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

Acta radiologica (Stockholm, Sweden : 1987)

PubMedID: 23528567

Kim BY, Yoon DY, Kim HC, Kim ES, Baek S, Lim KJ, Seo YL, Yun EJ, Choi CS, Bae SH. Thrombophlebitis of the internal jugular vein (Lemierre syndrome): clinical and CT findings. Acta Radiol. 2013;54(6):622-7.
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.