Internal Jugular Vein Thrombosis in Isolated Tuberculous Cervical Lymphadenopathy

Abstract

Tuberculosis is a common infectious disease with a high prevalence in developing countries and presents a major public health issue. Internal jugular vein (IJV) thrombosis is a rare complication in tuberculous cervical lymphadenopathy. We report a case of 26-year male patient with a history of low-grade evening rise in fever, dry cough, loss of appetite, and loss of weight with swelling in lower neck on right side. Ultrasonography (USG) neck showed well-defined hypoechoic lymph nodes posterior to right IJV and common carotid artery in the lower neck at level IV and in the right supraclavicular region showing central necrotic areas with adjoining IJV thrombosis. The association between tuberculosis and deep vein thrombosis is rare. Awareness of IJV thrombosis in isolated cervical lymphadenopathy needs high diagnostic suspicion and prompt treatment to avoid fatal complication. Our case is rare as there was isolated tuberculous cervical lymphadenopathy with adjoining IJV thrombosis. Both USG and computed tomography (CT) are accurate and reliable radiological investigations for detecting IJV thrombosis along with cervical lymph nodes. They are useful in assessing surrounding soft tissue and fat planes and knowing the size and extent of cervical lymphadenopathy. USG is inexpensive and readily available for monitoring response to treatment.

Analysis of a First Unilateral and Then Bilateral Internal Jugular Vein Thrombosis in a Heroin User

“…8 The IJV thrombosis results from disturbance of pathophysiological mechanisms in Virchow's triad of endothelial damage, stasis, and hypercoagulable state. 9,10 The report dedicated to analysis of physical and geographical injecting sites among injecting drug users 11 stated that drug addicted persons are using neck as a possible site of drug injections in 10% of cases. Rafful et al emphasized that IJV thrombosis and deep neck infections in a neck injected drug users are requiring the medication therapy and possibly surgeries and other care procedures.…”

October’s 2019 Full Issue PDF

“…[6][7][8] What may seem contradictory to one of the Scopus "criteria for title (ie journal) selection, " which emphasized on a need to have diversity in "geographical distribution of editors. " 9 But a successful coverage of Radiology Case Reports and Oral and Maxillofacial Surgery Cases by Scopus indicates that if the journal meets all other 15 criteria 9 it can be included into Scopus database.…”