Abstract
A 19-year-old man had fever, sore throat, and general malaise for 4 days. Physical examination revealed exudative tonsillitis, a right submandibular lymph node, and swelling along the right sternocleidomastoid muscle. Initial results of a chest x-ray were normal. Blood cultures were positive for Fusobacterium necrophorum. Radionuclide venography with in vitro Tc-99m labeled red blood cells showed a delay in the right carotid-jugular complex blood flow. An ECHO Doppler examination demonstrated both a thickening of the wall and a partial thrombosis of the right internal jugular vein, suggesting thrombophlebitis. Lemierre syndrome (suppurative thrombophlebitis of the internal jugular vein secondary to an oropharyngeal infection) was diagnosed. The patient was given clindamycin, with good response.
Published Version
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