A large acute neck collection with internal jugular venous occlusion / thrombus in a previously healthy young patient.

Septic thrombophlebitis in neck infections is typically described as Lemierre syndrome - although the triad for this condition is completed by embolic disease (usually pulmonary deposits although endocarditis, septic arthritis and meningitis are also recognized) which was not present in this case.

However surgical drainage of the abscess did yield large numbers of Fusobacterium necrophorum which is the anaerobic organism which is classically associated with Lemierre syndrome. This Gram negative bacteria is part of the normal flora of the aerodigestive tract and is considered to result in these infections as a secondary response to mucosal disturbance in pharyngitis from other bacterial or viral causes.