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Answer: C. Lemierre Syndrome
- Neck CT – Right peritonsillar fluid collection with enhancing rim consistent with abscess. Additionally, septic thrombophlebitis of right internal jugular vein.
- Chest CT – Multiple pulmonary nodules bilaterally some of which show cavitation. Given neck findings, septic emboli are most likely etiology.
- Presentation: Fever and pharyngitis develop first followed by cough, chest pain, and shortness of breath once pulmonary findings develop.
- Treatment: Cultures followed by surgical drainage of abscess and long course antibiotic therapy depending of sensitivities. Supportive therapy.
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