• N Kodaka, C Nakano, T Oshio, and H Matsuse.
• Division of Respiratory Medicine, Department of Internal Medicine, Toho University Ohashi Medical Center, Meguro City, Tokyo, Japan.
• J Postgrad Med. 2024 Jan 1; 70 (1): 505250-52.

AbstractWe present a 19-year-old woman, a case of Lemierre syndrome, who presented with fever, sore throat, and left shoulder pain. Imaging revealed a thrombus in the right internal jugular vein, multiple nodular shadows below both pleura with some cavitations, right lung necrotizing pneumonia, pyothorax, abscess in the infraspinatus muscle, and multiloculated fluid collections in the left hip joint. After inserting a chest tube and administering urokinase for the pyothorax, a bronchopleural fistula was suspected. The fistula was identified based on clinical symptoms and computed tomography scan findings. If a bronchopleural fistula is present, thoracic lavage should not be performed as it may cause complications such as contralateral pneumonia due to reflux.

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