PNR Neck 2

History

14 yo M with neck swelling and tenderness

Major Findings

Left parapharyngeal and retropharyngeal phlegmon and edema without discrete abscess
Airway patent but displaced
Thrombophlebitis of the left internal and external jugular veins
Cervical lymphadenopathy
Sinus disease with chronic remodeling/demineralization, likely chronic allergic or fungal sinusitis
Nasal polyp in the left posterior nasal cavity
Small hypodensity in the anterior left nasal cavity may be a small subperiosteal collection

Teaching Points

Lemierre syndrome is a complication of oropharyngeal infection resulting in thrombophlebitiis of the internal jugular veins, which can lead to seeding of infection throughout the body (this patient had septic emboli on chest CT).

Article on deep neck space infections:

Accession: CL0724

Study description: CT NECK W/ CONTRAST