1/9. Early antibiotic treatment may prevent complete development of Lemierre's syndrome: experience from 2 cases.Lemierre's syndrome is a rare fulminant condition caused by an acute oropharyngeal infection, with secondary septic thrombophlebitis of the internal jugular vein complicated by multiple metastatic infections. Herein we report 2 patients with internal jugular vein thrombosis secondary to oropharyngeal infection, whose clinical course was indolent, and who were asymptomatic shortly after antibiotic therapy was begun. Careful examination of the neck in patients presenting with sore throat could help identify the typical 'cord sign'. In such cases, intravenous antibiotic treatment should be started as soon as possible to prevent development of metastatic infections and septicaemia characterizing Lemierre's syndrome.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
2/9. 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 = 1keywords = sore throat, throat (Clic here for more details about this article) |
3/9. Necrobacillosis--a resurgence?Necrobacillosis is a rare life threatening illness caused by fusobacterium necrophorum. It usually affects previously healthy adolescents and presents as symptomatic pharyngeal infection followed by bacteraemia and metastatic abscesses. A high degree of clinical suspicion is needed because there is often a delay between the presentation of sore throat and the development of systemic illness. The clinical and radiological features of four cases of necrobacillosis are reported and a review of the spectrum of manifestations of metastatic infection presented.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
4/9. The evolution of lemierre syndrome: report of 2 cases and review of the literature.lemierre syndrome (postanginal septicemia) is caused by an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. A high degree of clinical suspicion is necessary for diagnosis. fusobacterium necrophorum is the usual etiologic agent. The disease progresses in several steps. The first stage is the primary infection, which is usually a pharyngitis (87.1% of cases). This is followed by local invasion of the lateral pharyngeal space and IJV septic thrombophlebitis (documented in 71.5% of cases), and finally, the occurrence of metastatic complications (present in 90% of cases at the time of diagnosis). A sore throat is the most common symptom during the primary infection (82.5% of cases). During invasion of the lateral pharyngeal space and IJV septic thrombophlebitis, a swollen and/or tender neck is the most common finding (52.2% of patients) and should be considered a red flag in patients with current or recent pharyngitis. The most common site of metastatic infection is the lungs (79.8% of cases). In contrast to the preantibiotic era, cavitating pneumonia and septic arthritis are now uncommon. Most patients (82.5%) had fever at some stage during the course of the disease. Gastrointestinal complaints such as abdominal pain, nausea, and vomiting were common (49.5% of cases). An elevated white blood cell count occurred in 75.2% of cases. hyperbilirubinemia with slight elevation of liver enzyme levels occurred in one-third of patients, but frank jaundice was uncommon, in contrast to its high frequency reported in the preantibiotic era. We conclude that, most likely as a consequence of widespread antibiotic use for pharyngeal infections, the typical course of the disease has changed since Lemierre's original description. The typical triad in our series was: pharyngitis, a tender/swollen neck, and noncavitating pulmonary infiltrates. The previous classical description of severe sepsis with cavitating pneumonia and septic arthritis was not commonly seen in our review. mortality was low in our series (6.4%), but significant morbidity occurred, which was likely preventable by early diagnosis and treatment. The pathophysiology, natural history, diagnostic methods for internal jugular vein thrombosis, and management are discussed.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
5/9. Serious consequences of a sore throat.Lemierre's syndrome, caused by fusobacterium necrophorum, is a potentially fatal sequelae of a sore throat characterised by septicaemia, internal jugular vein thrombophlebitis and metastatic abscesses. The Chief Medical Officer reported in February 2001 that the incidence is increasing. Two cases seen in one year, with different presentations, are reported. The first patient presented with sepsis, jaundice, hepatic abscesses and portal vein/superior mesenteric vein thrombosis, whilst the second presented with sepsis, sore throat and internal jugular vein thrombophlebitis. Both patients were treated with antibiotics and anticoagulants with a favourable outcome.- - - - - - - - - - ranking = 6keywords = sore throat, throat (Clic here for more details about this article) |
6/9. critical care nurses be aware: Lemierre's syndrome is on the rise.Lemierre's syndrome (LS) typically occurs in previously healthy young adolescents and young adults who become acutely ill following an attack of pharyngotonsillitis. Also known as post anginal sepsis, those afflicted develop pyrexia, rigours and multiple metastatic abscesses that lead to septic thrombophlebitis of the internal jugular vein. In the pre-antibiotic era this particularly virulent syndrome had a mortality rate in excess of 90%, but since the introduction of antibiotics and the widespread treatment of throat infections, it has became almost unknown. However, due to a number of factors, including a reduction in the use of antibiotics for the treatment of sore throats, misdiagnosis and/or improvements in microbiology diagnostic techniques, several reports have indicated a resurgence of the condition. This has major ramifications for critical care nurses as LS is still associated with significant morbidity and mortality. This paper discusses the aetiology, pathophysiology, bacteriology, diagnosis and management aspects of this syndrome. A case study of a young woman is presented to illustrate the complexity of the condition, and highlight how early diagnosis and prompt initiation of appropriate intravenous antibiotic therapy ensured a favourable clinical outcome.- - - - - - - - - - ranking = 1.0212172910499keywords = sore throat, throat (Clic here for more details about this article) |
7/9. 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) |
8/9. Lemierre's syndrome: porphyromonas asaccharolytica as a putative pathogen.A case of Lemierre's syndrome is reported in which metastatic abscesses resulted from septic thrombophlebitis of the internal jugular vein secondary to bacterial pharyngitis. A 32-year-old male suffering from a painful left-sided neck mass, sore throat, and fever was admitted to our hospital. Computed tomography revealed thrombosis of the left internal jugular vein, septic pulmonary emboli, and a liver abscess. Blood culture showed porphyromonas asaccharolytica. Although empyema occurred transiently during the treatment, the patient recovered following prolonged antimicrobial therapy. Although Fusobacterium species are a well-known cause of Lemierre's syndrome, cases in whom porphyromonas species was isolated have scarcely been reported. Moreover, case reports from japan have been few.- - - - - - - - - - ranking = 1keywords = sore throat, throat (Clic here for more details about this article) |
9/9. Lemierre's syndrome: the link between a simple sore throat, sore neck and pleuritic chest pain.An unusual case of tonsillitis which showed progression to this rare syndrome despite treatment with intravenous antibiotics. Lemierre's syndrome is a rare condition characterised by a triad of: sepsis, thrombophlebitis of the internal jugular vein along with pleuropulmonary and/or distant metastatic abscesses. Diagnosis rests on a high index of suspicion and is confirmed by culture of Fusobacterium spp. from blood or infected sites. Radiological investigations are established aids for confirmation of diagnosis. Treatment is with appropriate antibiotics for at least 6 weeks and surgical drainage of abscesses if required. This case has been presented to highlight the mode of presentation, diagnostic tools employed and the management of the complications that featured in this condition.- - - - - - - - - - ranking = 4keywords = sore throat, throat (Clic here for more details about this article) |