2024 Volume 117 Issue 11 Pages 991-996
Venous thrombosis occurs mostly in the veins of the lower extremities and is relatively rare in the neck veins. Thrombosis involving the neck veins most often affects the internal jugular veins. In particular, Lemierre syndrome is known to be a disease characterized by the occurrence of septic thrombotic internal jugular phlebitis, potentially leading to the spread of sepsis and formation of abscesses in distant organs. We encountered a very rare case of external jugular vein thrombosis complicating peritonsillitis, and report this case with a review of the literature.
The patient was a 24-year-old woman who presented to us with a 2-day history of fever and sore throat, and gradually developed trismus. She visited her previous doctor who diagnosed her as having acute tonsilitis and referred her to our department for treatment. At the initial examination, swelling and redness of the bilateral palatine tonsils and swelling around the left tonsil were noted. We diagnosed the patient as having left peritonsillitis, and started the patient on treatment with antibiotics and betamethasone. Contrast-enhanced CT and neck ultrasound on day 2 of hospitalization revealed a thrombus in the left external jugular vein. In particular, cervical ultrasound showed some floating thrombi, and we started the patient on anticoagulant therapy and, heparin sodium administration. With these treatments, both the left peritonsillitis and the external jugular vein thrombosis resolved.
There is no consensus regarding anticoagulant therapy and surgical treatment for venous thrombosis in the head and neck region. In this case, antibiotic treatment and anticoagulant therapy were able to control the infection and eliminate the thrombus, suggesting a good therapeutic effect.
