Lemierre's syndrome mimicking leptospirosis.

Lemierre's syndrome is a suppurative thrombophlebitis involving the internal jugular vein, most commonly associated with Fusobacterium necrophorum, usually a complication of oropharyngeal infections. This syndrome is rare and is often overlooked. We present a case of sepsis mimicking initially severe leptospirosis (Weil's disease) due to acute febrile illness with multiorgan failure and hyperbilirubinemia. Finally, blood cultures revealed Fusobacterium necrophorum and computed tomography (CT) demonstrated bilateral pulmonary nodules and a thrombus in the right internal jugular vein. Early clinical suspicion is crucial so that appropriate diagnostic investigation and antibiotic therapy can be initiated to minimize the risk of life-threatening complications.

Oriental cholangiohepatitis from outside of Asia.

Oriental cholangiohepatitis, also known as recurrent cholangitis is exclusively endemic in Asian countries. Sporadic cases have been reported in the United States, however almost all cases have been seen in the Asian immigrants to the United States. We report a 31-year-old male from outside of Asia who developed oriental cholangiohepatitis.

Case report: spinal epidural abscess from Klebsiella pneumoniae.

We report a rare case of cervical spinal epidural abscess due to Klebsiella pneumoniae. While the most likely pathogen is Staphylococcus aureus, 2.5% of CNS infections have been attributed to Klebsiella pneumoniae. The source of infection in this case is suspected to be from cervical vertebra osteomyelitis/discitis that expanded to epidural space. Prompt drainage of the abscess by decompression with debridement is the key of management that is shown to decrease morbidity and mortality in epidural abscess patients.