PMC10370408_01
CT scan of the neck shows multiple peripheral contrast-enhancing abscesses in both sides of the neck (bilateral neck abscess).
OAEM-15-259-g0001.jpg
PMC10370408_01_OAEM-15-259-g0001.jpg
f0001
On neck examination, diffuse bilateral neck swelling and an infected wound on the right side of the neck, particularly in the submandibular space were detected (Figure 1). Contrast-enhanced computed tomography (CT) of the neck revealed multiple-hypodense lesions, the largest one measuring 4x4cm in size with peripheral contrast enhancement in the bilateral perivertebral, submental, anterior cervical, and right supraclavicular regions (Abscesses) (Figure 1).
Coronal and axial neck CT scan reveals inflamed soft tissue with loculated gas in the right side of the neck and supraclavicular region (necrotising fasciitis of the neck).
OAEM-15-259-g0002.jpg
PMC10370408_01_OAEM-15-259-g0002.jpg
f0002
Also, there is diffuse thickening and edema of the neck skin and subcutaneous area with emphysematous appearances in the subcutaneous area more prominent in the right of the neck and extending up to the right infra-clavicular region (Necrotising fasciitis of the neck) (Figure 2).
Axial chest CT shows several peripheral predominant nodules and some cavitation in both lungs (septic pulmonary embolism).
OAEM-15-259-g0003.jpg
PMC10370408_01_OAEM-15-259-g0003.jpg
f0003
While contrast-enhanced, CT imaging of the chest revealed multiple small-sized and peripherally located solid nodules and cavotation in the upper lobes of the lungs entering the examination field (Septic emboli) (Figure 3).
A CT scan of the neck reveals no contrast flow and filling defects in both jugular veins, indicating thrombosis.
OAEM-15-259-g0004.jpg
PMC10370408_01_OAEM-15-259-g0004.jpg
f0004
Bilateral common jugular veins were not visualized and showed a filling defect extending from the jugular foramen to the common jugular confluence, suggestive of high-grade partial occlusion due to septic thrombus formation (Lemierre syndrome) (Figure 4).