Abstract
Lemierre syndrome is a rare and potentially fatal complication of acute oropharyngeal infection, typically causing thrombophlebitis of the internal jugular vein and sepsis. We present the case of a 65-year-old female patient with type 2 diabetes mellitus who presented with otalgia and left hemifacial pain for eight days. Contrast-enhanced computed tomography of the neck showed a collection in the left submandibular space. Venous Doppler revealed thrombosis in the left external jugular vein, representing an anatomical variant or an atypical presentation of the disease. In secretion culture, Klebsiella pneumoniae was isolated. The patient was treated with antibiotics and anticoagulants and showed clinical improvement, so she was discharged after fourteen days of hospitalization. Lemierre syndrome represents a diagnostic challenge due to its nonspecific clinical presentation however, thrombophlebitis of the head and neck veins is usually the key finding, even in atypical variants.