CTICasesLemierre Syndrome
Imaging findings
Neck and chest CT in a severely ill, septic young female show a large retropharyngeal and parapharyngeal abscess. Chest CT demonstrates diffuse interstitial edema and multiple scattered nodular consolidations, several of which show rapid cavitation (Cheerios). Neck CT shows thrombosis of the external jugular vein but sparing of the internal jugular vein. Blood cultures grew Fusobacterium necrophorum.
Key takeaways
Lemierre syndrome is a life-threatening septic thrombophlebitis of the jugular vein, typically triggered by Fusobacterium necrophorum following an oropharyngeal infection. While classic Lemierre syndrome involves the internal jugular vein, variants can involve the external jugular vein or present without venous thrombosis. Septic emboli to the lungs present as multiple nodules that rapidly cavitate, resembling microabscesses.
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