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Introduction: Lemierre's syndrome is a rare disease typically manifested by thrombophlebitis of the jugular vein and septic embolism following a history of oropharyngeal infection. Fusobacterium necrophorum is the causative agent of Lemierre syndrome, commonly known as post-anginal sepsis. Case presentation: We reported a 24-year-old male who came to the emergency department complaining of a history of a sore throat, fever, malaise, fever, and neck swelling with a normal consciousness level. A laboratory examination showed leukocytosis and high C-reactive protein serum. Radiological diagnosis reveals an anterior neck abscess with left jugular vein thrombosis and left epidural abscess. The blood culture was positive for Fusobacterium necrophorum. The patient underwent surgical drainage and, at the same time, was treated with antibiotics and anticoagulant drugs. After 45 days, the patient improved clinically and was discharged. There were no other symptoms after a one-month follow-up clinically and neck ultrasonography. Clinical discussion: Lemierre's syndrome has historically had a high mortality rate, approximately up to 90% before antibiotics. The disease's incidence has declined gradually, leading it to become recognized as the "forgotten disease." Nevertheless, the incidence of Lemierre syndrome has been increasing over the last twenty to thirty years. Primary oropharyngeal infection, bacteremia, radiographic or clinical evidence of internal jugular vein thrombosis, and septic metastatic foci are the main clinical hallmarks of Lemierre's syndrome. Surgical debridement, antibiotics, and anticoagulants are the treatments of choice. Conclusion: Lemierre's syndrome with cranial epidural abscess is very rare. It is a forgotten disease. Nowadays, the prevalence is increasing. Awareness of clinical and radiological features will aid the prompt management of patients.
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Necrotizing fasciitis and/or Fournier's Gangrene is a rare, life-threatening soft tissue infection that, if not treated promptly, can immediately develop into systemic toxicity. It affects the genital, perineal, and perineal tissues, predominantly affecting men but can be seen in women. The diagnosis is often made clinically but radiologic examinations are helpful to determine the extent of the infection and can aid preoperative planning. Treatment consists of immediate and aggressive surgical debridement of necrotized tissue, broad-spectrum antibiotics, and early resuscitation. Here, we present a 56-year-old male patient with Fournier's gangrene and describe the physical examination, bedside sonographic, and computed tomography findings. These findings can aid in the evaluation of patients with worrying symptoms so that antibiotics can be administered immediately and specialists can be consulted as needed.
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Empyema necessitans (EN) is a rare complication of bacterial pneumonia, especially in children. It can be caused by many infectious agents, but Mycobacterium tuberculosis is the most common cause of EN. We report a 3-month-old girl who had EN on the 90th day of life, multidrug-resistant P. aeruginosa was isolated from her pleural fluid culture. We could not find another published report about EN caused by Pseudomonas aeruginosa (P. aeruginosa) in an infant. The case highlights that children presenting with fever and chest wall mass should be immediately imaged by chest computed tomography as there might be an urgent need for intervention.
