A case of craniocervical abscess with sinus thrombosis in Lemierre's syndrome

Abstract

A 74-year old gentleman with a cranio-cervical abscess failed to improve after incision and drainage and standard intravenous antibiotic therapy. Imaging demonstrated thrombosis of the internal jugular vein, sigmoid sinus and transverse sinus; and microbiological analysis isolated Fusobacterium nucleatum. The diagnosis of Lemierre's syndrome was confirmed, and he was effectively treated with appropriate antibiotics and anti-coagulation.

Keywords::

• anticoagulation
• internal jugular vein
• Lemierre's syndrome
• sigmoid sinus
• spinal epidural abscess
• thrombosis

Acknowledgement

We would like to acknowledge Dr Vivien Weston, Consultant Microbiologist, Nottingham University Hospital, for her advice in the management of this patient.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.