Suppurative thrombophlebitis of the internal jugular vein

Thrombophlebitis of the internal jugular vein, an anaerobic septicemia most frequently caused by fuso-bacteria, is rarely encountered in pediatrics. Indeed in two recent prospective studies of anaerobic infections in childhood, this entity was not observed in more than 200 cases of anaerobic disease.1,2 Significant morbidity is associated with embolic complications; mortality rates, which approach 20% in some series, have been caused in part by the failure of physicians to recognize this syndrome and the subsequent delay in the initiation of appropriate antibiotic therapy. This article reports our recent experience with three children with suppurative thrombophlebitis of the internal jugular vein and describes the use of ultrasonography and computed axial tomography in diagnosis and follow-up. We also analyze an additional nine cases gathered from the pediatric literature in the postantibiotic era.3–8