24-year old male with throat pain and fever and possible aggressive pharyngitis, tonsillar or peritonsillar, infection/ abscess.
Contrast-enhanced CT of the maxillofacial region and neck and related anatomy with images obtained in the balanced or venous vascular phase to ensure optimal visualization of both arterial and venous structures as well as possible reactive changes around infected collections. 0.5-3.0 mm thick sections were obtained in the axial plane and reformatted 3D and/or in the coronal and sagittal planes and viewed inter actively in 3 dimensions at the computer work station.
Pharyngitis and tonsillitis without abscess with a complete thrombosis of the left internal jugular vein raising the probability of anaerobic infection and risk of systemic Lemierre syndrome.
The treating EMS physician was contacted verbally immediately upon completion of the study because of the potentially highly aggressive nature of the infection due to the associated jugular thrombosis and therefore potential life-threatening complications of systemic manifestations of Lemierre syndrome.