Lemierre Syndrome: Magnetic Resonance Imaging and Computed Tomographic Appearance

Abstract

Lemierre syndrome consists of septic thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection, usually with Fusobacterium necrophorum. Septic metastatic emboli and distant infection are characteristic. We describe the imaging appearance of Lemierre syndrome in an adolescent female by both magnetic resonance imaging and computed tomography. This case illustrates the rapid onset and characteristic progression of the rare syndrome of Lemierre. In addition, we used magnetic resonance imaging to effectively distinguish between inflammatory venous thrombosis and abscess, thus avoiding surgery in our patient. Early directed antibiotic therapy is mandatory to ensure good outcome.

Human Infection withFusobacterium necrophorum(Necrobacillosis), with a Focus on Lemierre's Syndrome

“…and an anaerobic streptococcus. The third case had cerebrospinal fluid (CSF) suggestive of meningitis, but no organism was isolated (18). Thus, meningitis is a rare complication of Lemierre's syndrome (1.3%) but a relatively common complication (13/32; 41%) of otogenic F. necrophorum infection.…”

Lemierre’s syndrome: more than a historical curiosa

“…56 57 These techniques can also distinguish between localised abscess formation in the neck and internal jugular vein thrombophlebitis, thus potentially avoiding unnecessary surgery. 56 Localisation of abscesses requiring drainage is greatly assisted. 58 Septic emboli in the lungs may produce the characteristic radiographic appearance of multiple peripheral round and wedge shaped opacities that rapidly progress to cavitation.…”

Lemierre Syndrome Complicating Otitis Externa: Case Report and Literature Review

“…In the acute setting, contrastenhanced CT scan of the neck may be the optimal test, due to its lack of invasiveness (as opposed to venography), availability (as opposed to MRI), and ability to identify the extent of propagation of the thrombus, allowing more optimal operative planning (as opposed to duplex ultrasound) (7,8). CT demonstrates a dilatated IJV and low-attenuation intraluminal content and enhancement of the vessel wall and surrounding tissue (9).…”