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0:01

As if Ludwig's angina is not bad enough,

0:04

we have a second L-syndrome, Lemierre syndrome,

0:08

which can occur secondary to dental infection,

0:12

peritonsillar infection, tonsillitis or pharyngitis.

0:16

These are all very common in children

0:19

as well as in young adults,

0:21

and yet we don't see Lemierre syndrome

0:23

very often. Lemierre syndrome is,

0:25

as I mentioned in a previous section

0:28

in synopsis, inflammatory thrombophlebitis of the

0:32

jugular vein, which leads to septic emboli,

0:36

which go into the venous system

0:39

and end up in the lungs.

0:41

And here you see that there is necrotic areas

0:44

within the lungs from pneumonia, as well as from

0:48

septic thromboemboli into the lungs, secondary

0:52

to this patient's pharyngitis.

0:54

This is the normal jugular vein on the left side with

0:57

the carotid artery. Here is the carotid artery

1:00

on the right side.

1:01

This is thrombus within an enlarged

1:05

right jugular vein,

1:06

and you can see that it can go from there

1:09

into the right side of the heart,

1:10

out the pulmonary arteries into the lungs,

1:13

leading to septic emboli.

1:16

This entity is quite dear to me because,

1:20

as I will show you,

1:23

the very first article I ever wrote in my academic

1:27

career was CT demonstration

1:30

of postanginal sepsis,

1:32

which is another term for Lemierre syndrome

1:35

in 1985.

1:37

Probably before many of our current

1:40

viewers were even born.

Case 17 - Lemierre's Syndrome

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0:01

As if Ludwig's angina is not bad enough,

0:04

we have a second L-syndrome, Lemierre syndrome,

0:08

which can occur secondary to dental infection,

0:12

peritonsillar infection, tonsillitis or pharyngitis.

0:16

These are all very common in children

0:19

as well as in young adults,

0:21

and yet we don't see Lemierre syndrome

0:23

very often. Lemierre syndrome is,

0:25

as I mentioned in a previous section

0:28

in synopsis, inflammatory thrombophlebitis of the

0:32

jugular vein, which leads to septic emboli,

0:36

which go into the venous system

0:39

and end up in the lungs.

0:41

And here you see that there is necrotic areas

0:44

within the lungs from pneumonia, as well as from

0:48

septic thromboemboli into the lungs, secondary

0:52

to this patient's pharyngitis.

0:54

This is the normal jugular vein on the left side with

0:57

the carotid artery. Here is the carotid artery

1:00

on the right side.

1:01

This is thrombus within an enlarged

1:05

right jugular vein,

1:06

and you can see that it can go from there

1:09

into the right side of the heart,

1:10

out the pulmonary arteries into the lungs,

1:13

leading to septic emboli.

1:16

This entity is quite dear to me because,

1:20

as I will show you,

1:23

the very first article I ever wrote in my academic

1:27

career was CT demonstration

1:30

of postanginal sepsis,

1:32

which is another term for Lemierre syndrome

1:35

in 1985.

1:37

Probably before many of our current

1:40

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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