Lemierre's syndrome due to intratumoral abscess of the uvula

A rare case of spontaneous carotid sheath abscess presenting as a painful neck mass

Infections of the carotid arteries and sheath without any underlying etiology are extremely uncommon. In this article, we report the successful open repair of a right carotid sheath abscess in a 71-year-old woman with multiple comorbidities. The repair consisted of excision of the affected carotid segment and reconstruction by interposition of a reversed great saphenous vein graft. Postoperative Doppler ultrasound examination showed patent right carotid artery, and the patient demonstrated no recurrence postoperatively. This case suggests that, although rare, spontaneous carotid sheath remains a possible cause of neck mass, warranting high suspicion index for optimal treatment in a timely manner to avoid further complications.

Lemierre Syndrome as a Complication of Laryngeal Carcinoma

Lemierre syndrome is a rare condition characterized by a septic thrombophlebitis of the internal jugular vein with septicemia and metastatic foci of infection. It typically occurs as the result of an infection in the head and neck, most commonly pharyngitis. For reasons that are unclear, the incidence of Lemierre syndrome has been increasing over the past 15 years. Diagnosis of Lemierre syndrome is often delayed, and identification of internal jugular vein thrombosis is often the first indicator of its presence. We report a case of Lemierre syndrome associated with a laryngeal carcinoma.

Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome

The symptoms of a previously healthy 14-year-old female with an initial history of tooth pain and swelling of the left maxillary evolved to a progressive headache and altered neurological findings characterized by auditory hallucinations, sleep disturbances, and aggressiveness. She was brought to the emergency department after 21 days of the initial symptoms. An initial computed tomography (CT) scan showed frontal subdural empyema with bone erosion. The symptoms continued to evolve to brain herniation 24 hours after admission. A second CT scan showed a left internal jugular vein thrombosis. The outcome was unfavorable and the patient died on the second day after admission. The autopsy findings depicted rarefaction of the cranial bone at the left side of the frontal sinus, and overt meningitis. The severe infection was further complicated by thrombophlebitis of the left internal jugular vein up to the superior vena cava with septic embolization to the lungs, pneumonia, and sepsis. This case report highlights the degree of severity that a trivial infection can reach. The unusual presentation of the sinusitis may have wrongly guided the approach of this unfortunate case.