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Unilateral proptosis in Lemierre's syndrome variant
  1. Meng-Fang Shen1,
  2. Hung-Jen Chen1,2
  1. 1Division of Pulmonary and Critical Care Medicine, China Medical University Hospital, Taichung, Taiwan
  2. 2School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
  1. Correspondence to Dr Hung-Jen Chen, Division of Pulmonary and Critical Care Medicine, China Medical University Hospital, Taichung 40402, Taiwan; Redman0127{at}gmail.com

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A 47-year-old man, with a 10-year history of alcohol consumption, presented with a left cheek swelling for 14 days following self-extraction of two teeth. On the day of admission, he developed a low-grade fever, delirium and left eye proptosis (figure 1A). Laboratory analysis showed a white cell count of 21.6×109 cells/L with 79.8% neutrophils. C-reactive protein was 26.3 mg/dL. Blood chemistries were within normal limits except creatinine 2.2 mg/dL and sodium 128 mmol/L. CT imaging of the brain revealed left superior and inferior ophthalmic vein engorgement (figure 1B), suspected cavernous sinus thrombosis (CST) related and a tissue swelling over left pterygoid muscles, consistent with an abscess (figure 1C, arrow). Chest X-ray revealed mass-like lesions over the left-upper and right-lower lung fields (figure 1D).

Figure 1

A 47-year-old man developed a …

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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.

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