We report 3 cases of rare, life-threatening intracranial and internal jugular vein (IJV) thrombosis that were caused by common ENT infections. These infections included otitis media in a 6-year-old girl, tonsillitis in a 21-year-old woman, and odontogenic sepsis in a 56-year-old woman. All 3 patients were treated with culture-directed systemic antibiotics; 2 of them also required surgical drainage (the child and the older adult). The 2 adults also received therapeutic anticoagulation, which was continued until venous recanalization was documented; the duration of combined antibiotic and anticoagulation treatment was 6 weeks. All 3 patients made uneventful recoveries. Significant morbidities associated with intracranial and IJV thrombosis were avoided as a result of prompt diagnosis and judicious treatment.
Before the 20th century, the progression of ENT infections often led to systemic sepsis and eventual death. In 1936, Lemierre described a syndrome of anaerobic sepsis and internal jugular vein (IJV) thrombosis caused by oropharyngeal infections in a series of 20 patients, 18 of whom died.1 Intracranial and IJV thrombosis is a rare but still feared complication of ENT infections.