Journal of Reproductive Endocrinology & Infertility

Lemierre Syndrome in Pregnancy Achieved with In Vitro Fertilization

This is a case report of a 30-year-old female diagnosed with Lemierre Syndrome in the first trimester of pregnancy that was achieved via in vitro fertilization. Lemierre syndrome is a rare disease characterized by septic thrombophlebitis, usually involving the internal jugular vein (IJV), and typically incited by an oropharyngeal infection. The patient presented at 7 weeks gestation following a three-day history of neck pain, swelling, and restricted movement. Diagnosis was confirmed via MRI by the presence of thrombosis of the IJV and a phlegmon encompassing the retropharyngeal space. Treatment with intravenous antibiotics and anticoagulation resulted in rapid complete recovery. With increasing use of IVF in the United States, provider’s needs to be aware of the possible rare complications associated with hyperestrogenic states that often occur in conjunction with assisted reproductive techniques. A high index of suspicion is needed as complications may initially be asymptomatic and late in onset.

Essentials

• Lemierre Syndrome (LS) is a rare septic thrombophlebitis involving the internal jugular vein

• A pregnant woman was diagnosed with LS after successful in vitro fertilization (IVF)

• Pregnancy, especially following IVF, complicates the diagnosis and management of LS

• Treatment for LS includes antibiotic therapy with consideration of anticoagulation.

Author(s):

David Prokai, Bennett Gardner, Brian Brost, Louis Weinstein, Erika Johnston-MacAnanny

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