Demographics:
16 years old, Female
Indication:
Neck pain, fever
Findings
- Long segment occlusive thrombosis of the left anterior jugular vein with surrounding fat stranding. Thrombus extends into a bridging vein between the anterior and internal jugular veins, but does not extend into the internal jugular vein
- Thickening of the platysma muscle
- Enlarged, edematous left submandibular gland
- Several right upper lobe nodular opacities
- Reactive cervical lymphadenopathy without suppuration
- No tonsillar/peritonsillar or retropharyngeal abscess
Diagnosis
Lemierre syndrome
Reactive sialadenitis
Sample Report
Thrombophlebitis of the left anterior jugular vein, which in conjunction with the finding of several nodular opacities likely representing septic emboli in the right upper lobe is consistent with Lemierre syndrome. Consider chest CT for further evaluation. Thrombus extends near, but not into the left internal jugular vein.
Inflammatory changes extend superiorly with enlargement and edema of the left submandibular gland, consistent with reactive sialadenitis.
No tonsillar/peritonsillar or retropharyngeal abscess.
Reactive cervical adenopathy without suppuration.
Discussion