CTICasesLemierre Syndrome
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Imaging findings
Contrast-enhanced neck CT shows pharyngitis and thrombosis of the internal jugular vein. Chest CT demonstrates multiple peripheral, cavitating pulmonary nodules consistent with septic emboli, as well as areas of low attenuation in the atelectatic lower lobes representing microabscesses. Subsequent imaging reveals progression to large, loculated bilateral empyemas resisting gravity.
Key takeaways
Lemierre syndrome is a rare, life-threatening infection characterized by acute oropharyngeal infection complicated by septic thrombophlebitis of the internal jugular vein and metastatic septic emboli, most commonly to the lungs. Fusobacterium necrophorum is the typical pathogen, and pulmonary complications can quickly progress from septic emboli and parenchymal microabscesses to complex, bilateral empyemas.
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