RESUMEN
This case report illustrates a unique presentation of Lemierre's syndrome precipitated by Fusobacterium necrophorum. This case report describes a 20-year-old patient who developed Lemierre's syndrome secondary to a shoulder hematoma and neck abscess with multiple systemic complications in the absence of tonsillitis or oropharyngeal infection. Two weeks prior to presentation, the patient sustained a right shoulder injury and contracted COVID-19. Due to his Lemierre's syndrome, he developed right internal jugular vein and subclavian vein thrombosis, septic lung emboli, right sided Horner's syndrome, disseminated intravascular coagulation, pelvic collection, septic arthritis of pubic symphysis and osteomyelitis of the right pubic bone, and proximal left femoral shaft. The patient received non-operative and operative management to manage his Lemierre's syndrome including surgical drainage, antibiotics, and anticoagulation; he was discharged following an extended hospital stay. This case report highlights a rare presentation of Lemierre's syndrome secondary to a shoulder hematoma in a COVID-19 positive patient, and its potential systemic and life-threatening complications. Its importance is highly relevant in the context of the COVID-19 pandemic. Further studies are warranted to explore the effect of preceding COVID-19 infections on the microbiological profile in Lemierre's syndrome.
RESUMEN
Reflex anuria is a rare phenomenon that is caused by trauma or irritation to one kidney or ureter. It has been described in unilateral ureteric obstruction and after surgical procedures involving the ureters and bladder. Here we present a case of a 33-year-old female, presenting with right-sided loin to groin pain, which eventually lead to oliguria and required bilateral nephrostomies as retrograde stent insertions failed. Although an etiology was not identified, we postulate that unilateral ureteric obstruction triggered reflex anuria. Although reflex anuria is a rare presentation, it should be included in the differential diagnosis once all other causes of AKI have been ruled out. Furthermore, this report will show that bilateral nephrostomies should be considered as a viable treatment option for reflex anuria.
