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Case 17 - Lemierre's Syndrome

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As if Ludwig's angina is not bad enough,

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we have a second L-syndrome, Lemierre syndrome,

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which can occur secondary to dental infection,

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peritonsillar infection, tonsillitis or pharyngitis.

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These are all very common in children

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as well as in young adults,

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and yet we don't see Lemierre syndrome

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very often. Lemierre syndrome is,

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as I mentioned in a previous section

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in synopsis, inflammatory thrombophlebitis of the

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jugular vein, which leads to septic emboli,

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which go into the venous system

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and end up in the lungs.

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And here you see that there is necrotic areas

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within the lungs from pneumonia, as well as from

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septic thromboemboli into the lungs, secondary

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to this patient's pharyngitis.

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This is the normal jugular vein on the left side with

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the carotid artery. Here is the carotid artery

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on the right side.

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This is thrombus within an enlarged

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right jugular vein,

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and you can see that it can go from there

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into the right side of the heart,

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out the pulmonary arteries into the lungs,

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leading to septic emboli.

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This entity is quite dear to me because,

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as I will show you,

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the very first article I ever wrote in my academic

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career was CT demonstration

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of postanginal sepsis,

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which is another term for Lemierre syndrome

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in 1985.

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Probably before many of our current

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viewers were even born.

Report

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Neuroradiology

Head and Neck

Emergency

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