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Brief ReportBrief Report

Internal Jugular Vein Septic Thrombophlebitis (Lemierre Syndrome) as a Complication of Pharyngitis

Andrew P. Wong, Maurice L. Duggins and Tara Neil
The Journal of the American Board of Family Medicine May 2015, 28 (3) 425-430; DOI: https://doi.org/10.3122/jabfm.2015.03.140131
Andrew P. Wong
From the Via Christi Family Medicine Residency, Wichita Center for Graduate Medical Education (APW) and the Via Christi Family Medicine Program (MLD, TN), Kansas University School of Medicine, Wichita.
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Maurice L. Duggins
From the Via Christi Family Medicine Residency, Wichita Center for Graduate Medical Education (APW) and the Via Christi Family Medicine Program (MLD, TN), Kansas University School of Medicine, Wichita.
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Tara Neil
From the Via Christi Family Medicine Residency, Wichita Center for Graduate Medical Education (APW) and the Via Christi Family Medicine Program (MLD, TN), Kansas University School of Medicine, Wichita.
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    Figure 1.

    Trends in pertinent laboratory values during the hospital course. The patient was discharged from the hospital on day 7. Laboratory values on day 12 are after discharge. The dashed orange line marks the initiation of clindamycin. The dotted–dashed orange line marks the change in antibiotics to high-dose ceftriaxone, vancomycin, and metronidazole. The dotted black line marks the initiation of dexamethasone taper. ANC, absolute neutrophil count; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; WBC, white blood cells.

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    Figure 2.

    Computed tomography of the neck and soft tissues demonstrating complete occlusion of the right internal jugular (IJ) vein extending from just inferior to the jugular foramen to the lower neck. The black arrows mark the location of the right IJ vein. The right IJ vein is patent just inferior to the jugular foramen (A), before it begins to narrow at the level of the inferior maxillary sinuses (B) and becomes completely occluded (C) until distally at the level of the lower neck, where it can again be seen filled with contrast (D). A distinct difference can be seen when compared with the left IJ vein.

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    Figure 3.

    Coronal section of computed tomography angiography of the chest showing moderate-sized bilateral pleural effusions and atelectasis (black arrows).

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The Journal of the American Board of Family     Medicine: 28 (3)
The Journal of the American Board of Family Medicine
Vol. 28, Issue 3
May-June 2015
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Internal Jugular Vein Septic Thrombophlebitis (Lemierre Syndrome) as a Complication of Pharyngitis
Andrew P. Wong, Maurice L. Duggins, Tara Neil
The Journal of the American Board of Family Medicine May 2015, 28 (3) 425-430; DOI: 10.3122/jabfm.2015.03.140131

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Internal Jugular Vein Septic Thrombophlebitis (Lemierre Syndrome) as a Complication of Pharyngitis
Andrew P. Wong, Maurice L. Duggins, Tara Neil
The Journal of the American Board of Family Medicine May 2015, 28 (3) 425-430; DOI: 10.3122/jabfm.2015.03.140131
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