What is the most likely diagnosis?
- 14 year-old female with left facial pain and edema
Gray-scale and color Doppler images of left internal jugular vein
- Hansen's Disease
- Atherosclerotic plaque
- Venous Dissection
- Lemierre Syndrome
- Lymphoma
Additional Images - Axial, sagittal and coronal images from a contrast-enhanced CT scan of the neck
Additional Images
Axial, sagittal and coronal images from a contrast-enhanced
CT scan of the neck
Answer:
4. Lemierre Syndrome
More (Click Discussion Tab)
Lemierre Syndrome
General Considerations
- Seen in young adults who may be otherwise healthy
- Refers to rare thrombophlebitis of the internal jugular vein with distant metastatic sepsis seen in the setting of initial oropharyngeal infection (pharyngitis / tonsillitis with or without peri-tonsillar abscess
- More common in pre-antibiotic era
- 90% mortality before antibiotics
- Most common pathogen is Fusobacterium necrophorum