CTICasesLemierre's Syndrome (Septic Emboli from Neck Abscess)
▶ Watch on YouTube — age-restricted, cannot embed here
Imaging findings
The initial radiograph showed some histoplasmosis and ill-defined, nodular areas of consolidation, perhaps more than two. A CT scan showed gas around the tonsil, areas of necrosis, and gas tracking in a vein extending down the neck with enlarged lymph nodes, consistent with a peritonsillar abscess with possible gas formation tracking into the vein. The CT also demonstrated a reversed halo or atoll sign, with a mass area showing peripheral consolidation and central ground glass. There were septal lines, other ill-defined nodules of varying sizes throughout the lungs (some with air bronchograms, some potentially cavitating), and pleural effusions.
Key takeaways
This picture is consistent with septic emboli in a patient who was septic with gram-negative rods. This is a case of Lemierre's syndrome, characterized by thrombosis or vascular involvement extending into the chest, often originating from a pharyngeal microtrauma or abscess that seeds the lungs.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Fibrosing Mediastinitis (Histoplasmosis-related)Inflammatory
- Obstructing Squamous Cell Carcinoma with Distal Abscess, Drowned Lung, and Bronchopleural FistulaNeoplastic
- Takayasu's ArteritisAutoimmune
- Caseous Mitral Annulus Calcification (CMAC)Metabolic
- Anomalous Left Circumflex Artery from the Pulmonary ArteryCongenital
- Congenital Absence of Right Pulmonary Artery with Multi-focal AdenocarcinomaNeoplastic
- Diffuse Pulmonary Ossification (Dendriform Type)Metabolic
- Glomus Tumor of the TracheaNeoplastic
See all cases from April 11, 2014 →