1/33. retropharyngeal abscess on a Ga-67 scan: a case report.A retropharyngeal abscess is a potentially fatal deep neck infection. Classical symptoms include fever, neck swelling, sore throat, dysphagia, and cervical rigidity. Sometimes small children present with nonspecific symptoms. We report a rare case whereby the Ga-67 citrate scan was the first investigation to reveal an inflammatory process in the retropharyngeal or submastoid region of a 3-year-old child with sepsis. This directed the line of investigation to a more precise anatomic imaging modality, CT scanning, to localize the abscess. With prompt administration of intravenous antibiotics, the child recovered quickly and did not require surgery. The Ga-67 scan is thus a useful screening test to detect inflammatory foci because of its high sensitivity. It is also valuable in the follow-up of the patient's response to therapy.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
2/33. Respiratory failure as a complication of pharyngitis: Lemierre's syndrome.The emergence of drug-resistant organisms has promoted increased calls for judicious use of antibiotics in cases of pediatric pharyngitis. Although these recommendations are largely justified, the case of a 16-year-old girl with pharyngitis is reported to alert readers to an unusual complication, Lemierre's syndrome. This complication of pharyngitis and its relevance to changing practice habits are discussed.- - - - - - - - - - ranking = 9.5904308976879keywords = pharyngitis (Clic here for more details about this article) |
3/33. Lemierre's syndrome. sepsis complicating an anaerobic oropharyngeal infection.Previously healthy people without interfering conditions are rarely affected by anaerobic infections. We report a young patient with extended septic emboli in the lungs, after an episode of sore throat, due to anaerobic bacteremia with fusobacterium necrophorum. The first description of oropharyngeal infection complicated by sepsis was given by Lemierre in 1936. knowledge of Lemierre's syndrome should lead to early recognition and prompt action against this sporadic and possible fatal illness.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
4/33. Lemierre's syndrome complicated by carotid thrombosis.Lemierre's syndrome, also known as postanginal sepsis, is a rare condition that presents as an increasing sore throat due to acute pharyngitis or tonsillitis and progresses to sepsis, due to suppurative thrombophlebitis of the internal jugular vein. We present an atypical case of Lemierre's syndrome complicated by carotid thrombosis. The etiological factors and the diagnostic and therapeutic measures are discussed.- - - - - - - - - - ranking = 2.3700615568126keywords = pharyngitis, sore throat, throat (Clic here for more details about this article) |
5/33. Lemierre's syndrome: an unusual cause of sepsis and abdominal pain.OBJECTIVE: To describe a patient with Lemierre's syndrome who presented with acute abdominal findings and to describe the evaluation and treatment of this syndrome. DESIGN: Case report. SETTING: A 38-bed, pediatric intensive care unit at a tertiary care children's hospital. PATIENT: One patient presenting with signs of severe sepsis and acute abdominal pain. INTERVENTIONS: Intravenous hydration, inotropic support, thoracostomy tube drainage of a pleural effusion, and prolonged antimicrobial therapy. MEASUREMENT AND MAIN RESULTS: The patient presented with severe sepsis and abdominal pain. After fusobacterium necrophorum grew in blood cultures, anaerobic antimicrobial therapy was initiated. Doppler duplex ultrasonography and magnetic resonance venography demonstrated thrombus formation in the left internal jugular vein. Computed tomography of the chest demonstrated bibasilar lung nodules consistent with septic emboli. The patient was treated with ampicillin-sulbactam and metronidazole intravenously for 3 wks, followed by a 3-wk course of oral amoxicillin/clavulanate. He had a good recovery, and his thrombus had resolved at the time of discharge. CONCLUSION: Lemierre's syndrome occurs in young, otherwise healthy patients, and it thus needs to remain high on the differential diagnosis for this group of patients presenting with severe sepsis. The diagnosis can be confounded by a lack of symptoms of pharyngitis at the time of presentation and end-organ dysfunction associated with severe sepsis, suggesting alternative sources of infection.- - - - - - - - - - ranking = 1.3700615568126keywords = pharyngitis (Clic here for more details about this article) |
6/33. A premature infant with fulminant meningococcal septicaemia.The case is described of a 10-week-old preterm infant, a twin boy born at 34 weeks of gestational age. The day after a hernia operation he had a rapidly progressive fulminant neisseria meningitidis serogroup B septicaemia, of which he died despite immediate and adequate treatment. No secondary cases occurred among other infants on the neonatal intensive care unit. Epidemiological investigation revealed that of 185 bacterial throat cultures performed on 17 infants on the ward, 37 close relatives to the infants and 131 medical personnel in contact with the deceased patient, 4 (2.2%) were asymptomatic carriers of N. meningitidis. serotyping and pulsed-field gel electrophoresis of the genomic dna of the N. meningitidis isolates revealed that the infant and his father had closely related strains.- - - - - - - - - - ranking = 0.05915005925849keywords = throat (Clic here for more details about this article) |
7/33. Streptococcal pharyngitis and epiglottitis in a newborn infant.We describe a newborn infant with streptococcus sanguis septicaemia and concomitant upper airway obstruction due to epiglottitis and pharyngitis. This rare infection of the supraglottic region was treated with endotracheal intubation and antibiotics. Full recovery occurred within 4 days.- - - - - - - - - - ranking = 6.8503077840628keywords = pharyngitis (Clic here for more details about this article) |
8/33. Lemierre's syndrome: the forgotten disease. An unusual presentation of sepsis.A 19-year-old girl presented with a septical condition with fever of 40 degrees C, swelling of the right sternocleidomastoid region and abdominal pain. Except for a sore throat with pain strictly localized to the right side of her neck and fever over the last week there were no other clues in her past medical history. An abdominal ultrasound and MRT scan as well as a chest X-ray only showed non-specific findings. The diagnosis of Lemierre's syndrome was established by ultrasonographical detection of right jugular venous thrombosis and perivascular inflammation together with blood cultures positive for fusobacteria. The patient recovered within days after treatment was initiated with metronidazol according to the antibiogram. Lemierre's syndrome is a life-threatening disease especially in an age group which is less frequently affected by septicaemia. A history of sore throat, Fusobacterium positive blood cultures and ultrasonographical detection of jugular venous thrombophlebitis together with the knowledge of the "forgotten disease" will lead the way to the diagnosis.- - - - - - - - - - ranking = 2keywords = sore throat, throat (Clic here for more details about this article) |
9/33. Group A streptococcal puerperal sepsis with retroperitoneal involvement developing in a late postpartum woman: case report.Group A beta-hemolytic streptococci cause a wide range of infectious diseases such as pharyngitis, impetigo, rheumatic fever, and even septic shock. Group A streptococcal puerperal sepsis is uncommon today, but recent reports indicate a reemergence of virulent strains can cause toxic-mediated shock and multiple organ failure. We present a case report of a 29-year-old postpartum woman after cesarean section who presented group A streptococcal puerperal sepsis. Furthermore, we discuss the GAS strain in this patient and its relation with close contact among family members. The group A streptococci (GAS) were isolated from the patient's retroperitoneal fluid and from her husband's throat swab, respectively. Both isolates were shown to be identical: M type 1. It is well known that exotoxin A produced by M1 or M3 serotypes of the organisms plays a crucial role in streptococcal toxic shock syndrome (STSS). We conclude that in this patient, close contacts of persons with GAS appear to be at risk for colonization with identical strains of STSS-causing GAS such as M1 or M3 serotypes. Therefore, the appropriate antibiotic including antibiotic prophylaxis for close contact should be considered.- - - - - - - - - - ranking = 1.4292116160711keywords = pharyngitis, throat (Clic here for more details about this article) |
10/33. fusobacterium necrophorum-induced sepsis: an unusual case of Lemierre's syndrome.Classical Lemierre's syndrome is characterized by severe sepsis with metastatic abscess formation in young, previously fit people from a primary head or neck focus. The causative organisms are the anaerobic fusobacteria, most commonly fusobacterium necrophorum. We describe the evaluation, therapeutic interventions and management of a patient with Lemierre's syndrome who presented in septic shock with multiple organ dysfunction. The patient required immediate interventions including endotracheal intubation and mechanical ventilation, fluid resuscitation, inotropic support, bilateral thoracostomy tube drainage of empyemata and antimicrobial therapy. The unexpected isolation of fusobacterium necrophorum from blood cultures and empyema fluid necessitated a change of antibiotic regime to provide anaerobic cover. The patient required 4 weeks of intensive support including prolonged antimicrobial therapy, and after a further 2 weeks was discharged home from hospital. This case highlights the need to raise the awareness of 'the forgotten disease': Lemierre's syndrome. Its diagnosis may, as in this case, be confounded by a lack of symptoms of pharyngitis at the time of presentation, and end-organ dysfunction associated with severe sepsis, possibly suggesting an alternative source of infection. As appropriate antibiotics reduce mortality dramatically, clinicians need to be alert to Lemierre's syndrome and include it in the differential diagnosis in young but otherwise healthy patients presenting with severe sepsis.- - - - - - - - - - ranking = 1.3700615568126keywords = pharyngitis (Clic here for more details about this article) |
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