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A 21-year-old female presented with non-specific symptoms of cough and sore throat. She rapidly became profoundly unwell, requiring intubation and ventilation. Clinical and radiological appearances were felt to be in keeping with Lemierre’s Syndrome (LS). The diagnosis of LS was confirmed when pleural fluid samples were found to contain Prevotella veroralis and Fusobacterium necrophorum. Due to worsening respiratory function the patient was commenced on veno-venous extracorporeal membrane oxygenation (VV-ECMO). She subsequently underwent three thoracic surgical procedures, undertaken via video-assisted thoracoscopic surgery (VATS). She began to improve and was successfully discharged from hospital after twenty-nine days. Repeat imaging six weeks later demonstrated complete resolution of the pathology. As the incidence of LS continues to rise in the modern era, so must clinician awareness of this uncommon and frequently life-threatening condition. Timely and accurate establishment of diagnosis remains a major challenge in treating a condition where prompt management with antibiotic therapy is vital for survival. In patients with associated respiratory and/or haemodynamic compromise, the utilisation of ECMO can help to salvage an otherwise seemingly futile situation. However, whilst the benefits of extracorporeal support are clear, ECMO also poses its own unique set of challenges and hence its employment must be considered on an individual case-by-case basis. This case, which is the first English-language case report of utilisation of VV-ECMO for management of LS, highlights that when used appropriately, ECMO can be instrumental in ensuring patients with profound, life-threatening sepsis and associated multi-organ failure are successfully managed, leading to total resolution of infection and complete patient recovery.

Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) Used in the Management of Lemierre's Syndrome