[Cervicofacial cellulitis complicated by internal jugular vein thrombosis]

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E Bonné¹, A Pourcelet², V Del Marmol¹

¹Service de dermatologie et vénérologie, université libre de Bruxelles, hôpital Erasme, route de Lennik 808, 1070 Bruxelles, Belgique.

Annales De Dermatologie Et De Venereologie

|June 8, 2020

Abstract

Introduction:

Cervicofacial cellulitis (CFC) is one of the most common dermatological infectious emergencies, and related morbidity and mortality are non-negligible.

Patients And Methods:

We describe the case of a 31-year-old male with left parotitis complicated by CFC with worsening over the previous week despite treatment with clindamycin and non-steroidal anti-inflammatory drugs. A cervicofacial computed tomography (CT) scan showed left internal jugular vein thrombosis (IJVT). Chest imaging showed no pleuropulmonary lesion, and bacteriological samples were negative. The patient received broad-spectrum antibiotic therapy and anticoagulants for 6 weeks. The outcome was quickly favourable.

Discussion:

It is essential to perform a cervicofacial contrast-enhanced CT scan for any CFC to map the affected areas, detect the primary infection and screen for loco-regional complications such as IVJT. The occurrence of IJVT in an infectious setting should prompt screening for septic emboli, especially pulmonary emboli, as well as performance of a chest CT scan. The presence of septic emboli associated with a recent ENT infection and of IJVT or Fusobacteriumnecrophorum in blood cultures are indicative of Lemierre's syndrome.

Conclusion:

IJVT is an uncommon complication of CFC that occurs either alone or as part of Lemierre's syndrome.

Keywords:

Cellulite cervico-faciale Cervico-facial cellulitis Internal jugular vein thrombosis Lemierre's syndrome Syndrome de Lemierre Thrombose veineuse jugulaire interne

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