Case of Lemierre's Syndrome Presenting With Neuro-Ophthalmologic Complications That Worsened After Stopping Corticosteroids.

Lemierre's syndrome (LS) is a rare disorder that manifests as septic internal jugular thrombophlebitis following a recent oropharyngeal infection. This article details a unique case of LS, where the patient presented to the emergency room with complaints of vomiting, headache, diplopia, and left eye pain. Due to a history of sore throat, headache, neck pain, fever, and nausea five days prior to admission, the patient was initially treated with amoxicillin/clavulanate for suspected tonsillitis. A positive meningeal sign and elevated temperature were observed during the clinical examination. Lumbar puncture (LP) was deferred based on imaging indicating potential increased intracranial pressure (ICP). Nevertheless, the patient received vancomycin, ceftriaxone, and dexamethasone as an initial course of treatment for presumed bacterial meningitis. Significant improvement was observed within the first four days of admission, with no subsequent episodes of fever, nausea, or headache. However, upon discontinuation of corticosteroid therapy, the patient experienced severe headaches and frequent vomiting. An urgent brain CT scan confirmed the extension of the left internal jugular vein (IJV) thrombosis to the ipsilateral sigmoid sinuses. Metronidazole and anticoagulant medication were initiated upon LS diagnosis. There is a paucity of discussions on corticosteroid use in LS, with no definitive statistics in the current literature. This case underscores the importance of recognizing and effectively managing interconnected clinical manifestations.

A Rare Case of Chickenpox Infection Complicated by Hip Septic Arthritis.

Chickenpox represents a viral malady characterized by the emergence of vesicular skin eruptions. This ailment is frequently encountered during childhood and typically manifests a benign course devoid of complications. Among the prevalent complications, secondary bacterial skin infections ranging from superficial impetigo to subcutaneous abscesses are most frequently observed. Instances of musculoskeletal complications, such as septic arthritis and osteomyelitis, are rarely observed. In any patient presenting complaints of bone pain or arthralgia, either during varicella eruptions or during the healing process, it is imperative to maintain a vigilant consideration for the potential manifestation of septic arthritis and osteomyelitis. Timely diagnosis holds paramount importance, as the administration of appropriate antibiotics can effectively forestall the necessity for surgical interventions and mitigate the risk of sequela. In this context, we present a case wherein chickenpox resulted in the complication of right hip septic arthritis.