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Erschienen in:
01.12.2015 | Clinical Practice: Clinical Images
MRSA-Associated Lemierre’s Syndrome in an Intravenous Drug User
Erschienen in: Journal of General Internal Medicine | Ausgabe 12/2015
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A 24-year-old woman with a history of intravenous drug use presented with 5 days of fevers, right-sided neck pain, and odynophagia. Physical and laboratory examination revealed tender swelling of the right neck and neutrophil-predominant leukocytosis. Computed tomography demonstrated a large right retropharyngeal fluid collection with associated stranding, right internal and external jugular vein thrombi, and multiple peripheral nodular and wedge-shaped pulmonary opacities representing septic emboli (Fig. 1) consistent with Lemierre’s syndrome. The patient underwent emergent incision and drainage of the abscess and received broad-spectrum antibiotics. Peripheral blood and abscess cultures grew methicillin-resistant Staphylococcus aureus (MRSA). The patient was stable postoperatively and completed 4 weeks of intravenous antibiotics.
Figure 1
Computed tomography with contrast of the neck (a) and chest (b, c). Panel A shows thrombosis of the right internal jugular vein (arrow). Panel B shows a large abscess (arrow). Panel C shows multiple peripheral nodules (arrow) and a wedge-shaped infarct (circle) consistent with septic pulmonary emboli.
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