A 45-year-old previously healthy female presented to the emergency department with the left arm and neck swelling and fever. 

The patient underwent to ultrasound of the neck (not provided) demonstrating left internal jugular vein thrombosis.

Contrast-enhanced CT of the neck and chest revealed thrombus along the left internal jugular vein consistent with septic thrombosis of the internal jugular vein and retropharyngeal hypodense collection/edema and mild left-sided mild pleural effusion.

Lemierre syndrome is a rare and potentially lethal entity. It consists of internal jugular venous thrombosis following a primary oropharyngeal infection with development of distant septic emboli, most often involving the lungs.

These are the classic imaging triad, as present in the case above.