Presentation

Patient presents with fever and sore throat.

Clinical differential diagnosis

Concern for deep neck infection.

Findings

Neck CT:

There is extensive swelling of the left oropharynx with enlargement of the palatine tonsil with a small peritonsillar abscess. There is extensive inflammatory change that extends laterally into the parapharyngeal space and into the retropharyngeal space.

There is a filling defect within the left internal jugular vein consistent with a clot.

There are multiple areas of ground glass opacity throughout the lungs consistent with septic emboli.

Treatment

Antibiotics. Anticoagulation is controversial.

Diagnosis

Septic thrombophlebitis (AKA Lemierre's Syndrome)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015694/