Deep cervical infection?

Introduction: Inflammatory cervical swelling may have several causes. The jugular vein thrombosis is a rare entity, often forgotten. Most frequently arises due to a cervical sepsis by the use of a central venous catheter or intravenous drug abuse (drug addicts). Rarely, is secondary to a hypercoagulability state associated with a visceral carcinoma (Trousseau Syndrome). Material and Methods: The authors present the case of a 65 years old male, who used the ENT Emergency Service due to a painful left cervical swelling with local and systemic inflammatory signs of 3 days duration. Results: An cervical ultrasound suggested a neck abscess. CT was performed and confirmed the ultrasound results. Because of its location in the path of the internal jugular vein, we requested re-evaluation by CT with intravenous contrast and doppler ultrasound, obtaining the diagnosis of thrombosis of the internal jugular vein. Further studies were conduct to clarify the hypercoagulability state, since the patient had no known predisposing factor. Finally the diagnosis of unresectable gastric carcinoma was made. Discussion and Conclusion: The ENT must be aware and be able to understand any cervical imagiologic studies. A deep knowledge of the anatomical imagiología is important for the diagnosis of jugular thrombosis. When we have a case of spontaneous jugular thrombosis, we must look for possible visceral carcinoma.