Lemierre syndrome: thrombosis of the internal jugual vein after tonsillectomy

Background. Thrombosis of the internal jugular vein is a rare and critical disease which can also be a complication of a benign oropharyngeal infection (Lemierre syndrome). Patient. A 62 year old patient underwent septomplasty, endonasal turbinectomy, paranasal sinus surgery and tonsillectomy. The postoperative course was uneventful until the 11th post operative day when the patient reported a painful swelling on the right side of the neck. Color Doppler ultrasonography demonstrated thrombosis of the right internal jugular vein and a CT-scan showed a right sided cervical phlegmonous soft tissue inflammation originating from the right oropharynx. Despite immediate intravenous antibiotic treatment, the patient developed a septic infection and resection of the jugular vein was conducted. Conclusion. Lemierre syndrome is a rare condition which may also follow tonsillectomy. Under septic conditions, the resection of the internal jugular vein has to be performed to avoid serious complications.