CT neck with IV contrast. Axial contrast-enhanced CT of the neck shows an enlarged, hyperenhancing left palatine tonsil suggestive of acute tonsillitis (*). Inflammatory changes (black arrows) spread to the adjacent left carotid space with loss of the normal fat planes. Nonopacificiation of the left internal jugular with a hyperenhancing wall and surrounding soft tissue correspond to thrombosis and thrombophlebitis. CT: computed tomography; IV: intravenous