Abstract

An otherwise healthy 30 year old man was admitted with a two week history of odynophagia, severe left cervical pain, and fever. Plasma inflammatory parameters were elevated. Ultrasound showed an intraluminal filling defect in the left internal jugular vein (A, arrow), a sign of venous thrombosis. Computed tomography angiography confirmed the jugular findings (B) and also showed a left tonsillar phlegmon and bilateral cavitated nodules in the pulmonary parenchyma, associated with septic emboli. The patient started empirical intravenous piperacillin–tazobactam and anticoagulation with low molecular weight heparin. Blood cultures were positive for Fusobacterium necrophorum. After 12 days, patient was discharged with good recovery.Image 1

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