Thrombophlebitis of the internal jugular vein (Lemierre syndrome): clinical and CT findings

Background Thrombophlebitis of the internal jugular vein (IJV) secondary to neck infection (so-called Lemierre syndrome) is a rare disease. Purpose To evaluate the clinical and CT findings in patients with thrombophlebitis of the IJV. Material and Methods The clinical and contrast-enhanced neck CT f...

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Published in:Acta radiologica (1987) 2013-07, Vol.54 (6), p.622-627
Main Authors: Kim, Bo Yeon, Yoon, Dae Young, Kim, Hyeong Chul, Kim, Eun Soo, Baek, Sora, Lim, Kyoung Ja, Seo, Young Lan, Yun, Eun Joo, Choi, Chul Soon, Bae, Sang Hoon
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - therapeutic use
Anticoagulants - therapeutic use
Contrast Media
Female
Humans
Iohexol
Lemierre Syndrome - diagnostic imaging
Lemierre Syndrome - drug therapy
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed - methods
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Summary:Background Thrombophlebitis of the internal jugular vein (IJV) secondary to neck infection (so-called Lemierre syndrome) is a rare disease. Purpose To evaluate the clinical and CT findings in patients with thrombophlebitis of the IJV. Material and Methods The clinical and contrast-enhanced neck CT findings were retrospective analyzed in 10 patients (eight men, two women; mean age, 62.9 ± 8.3 years) with thrombophlebitis of the IJV. Results Five patients (50%) had complications, including pneumonia (n = 3), neck abscess (n = 1), and thrombophlebitis of cerebral venous sinus (n = 1). All patients, except two who were lost to follow-up, had improved after antibiotics and anticoagulation therapy. Nine (90%) patients had underlying infectious processes in the neck. Contrast-enhanced neck CT of 12 IJVs (five right, three left, and two bilateral) affected by thrombophlebitis demonstrated > 5 cm in length (n = 8, 67%), ovoid shape (n = 7, 58%), complete occlusion of the lumen (n = 10, 83%), circumferential (n = 11, 92%), smooth (n = 8, 67%), and thick (≥4 mm) (n = 8, 67%) rim enhancement, and adjacent soft tissue swelling (n = 11, 92%). Conclusion Contrast-enhanced CT is useful in the diagnosis of thrombophlebitis of the IJV; characteristic CT findings of this unusual entity may be the main clue to the correct diagnosis.
ISSN:0284-1851
1600-0455
DOI:10.1177/0284185113481019