rss
BMJ Case Reports 2013; doi:10.1136/bcr-2012-007647
  • CASE REPORT

Atypical presentation of Lemierre syndrome: role of imaging

  1. Santosh Kumar3
  1. 1Department of Radiodiagnosis, King George's Medical University, Lucknow, Uttar Pradesh, India
  2. 2Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
  3. 3Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr Manoj Kumar, docmdeo{at}gmail.com

Summary

A 51-year-old male patient presented with breathlessness for 10 days. Chest radiograph revealed bilateral moderate pleural effusion. Ultrasound-guided diagnostic pleural aspirate revealed sterile transudative fluid. CT thorax revealed bilateral moderate pleural effusion with partial collapse of both lower lobes and thrombus in right brachiocephalic vein. Two-dimensional-echo revealed circumferential pericardial effusion with mild pericardial thickening and moderate tricuspid regurgitation. Cardiolipin antibodies were within normal limits. d-Dimer assay and C reactive protein were markedly raised. During the period of investigations, the patient had developed mild swelling and pain in right upper limb for which colour Doppler ultrasonography of his right upper limb and neck regions were done. Thrombi in right internal jugular, subclavian and brachiocephalic veins were noted. CT angiography, CT abdomen and chest confirmed the above findings. However, extent of the thrombus and lung lesions was better delineated by CT angiography. We have highlighted the pathognomonic imaging findings of Lemierre syndrome.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article