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1.
BMJ Case Rep ; 13(10)2020 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-33040042

RESUMO

The SARS-CoV-2 outbreak has disrupted the delivery of routine healthcare services on a global scale. With many regions suspending the provision of non-essential healthcare services, there is a risk that patients with common treatable illnesses do not receive prompt treatment, leading to more serious and complex presentations at a later date. Lemierre's syndrome is a potentially life-threatening and under-recognised sequela of an oropharyngeal or dental infection. It is characterised by septic embolisation of the gram-negative bacillus Fusobacterium necrophorum to a variety of different organs, most commonly to the lungs. Thrombophlebitis of the internal jugular vein is frequently identified. We describe an atypical case of Lemierre's syndrome involving the brain, liver and lungs following a dental infection in a young male who delayed seeking dental or medical attention due to a lack of routine services and concerns about the SARS-CoV-2 outbreak.


Assuntos
Abscesso Encefálico , Infecções por Coronavirus , Cuidados Críticos/métodos , Diagnóstico Tardio , Fusobacterium necrophorum , Abscesso Hepático Piogênico , Nódulos Pulmonares Múltiplos , Pandemias , Pneumonia Viral , Quarentena , Doenças Dentárias , Antibacterianos/administração & dosagem , Anticoagulantes/administração & dosagem , Betacoronavirus , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/etiologia , Deterioração Clínica , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Diagnóstico Diferencial , Fusobacterium necrophorum/isolamento & purificação , Fusobacterium necrophorum/patogenicidade , Humanos , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/etiologia , Síndrome de Lemierre/fisiopatologia , Abscesso Hepático Piogênico/diagnóstico por imagem , Abscesso Hepático Piogênico/etiologia , Abscesso Hepático Piogênico/cirurgia , Imagem por Ressonância Magnética/métodos , Masculino , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/etiologia , Pandemias/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Quarentena/métodos , Quarentena/psicologia , Tomografia Computadorizada por Raios X/métodos , Doenças Dentárias/complicações , Doenças Dentárias/diagnóstico , Doenças Dentárias/microbiologia , Resultado do Tratamento , Adulto Jovem
2.
J Infect Public Health ; 13(9): 1360-1362, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32507402

RESUMO

A pre-school aged boy presented to the Pediatric Emergency Department with a high grade fever and neck pain and stiffness. Blood culture was positive for methicillin-sensitive Staphylococcus aureus (MSSA) and Doppler ultrasound of the neck revealed partial thrombosis of the left internal jugular vein. He was diagnosed with Lemierre's syndrome (LS) and treated with a prolonged course of antibiotics and anticoagulation. After discharge home, he was followed in the outpatient clinics and had a full recovery. This case report will highlight the presentation of LS and will briefly review the microbiology of this condition.


Assuntos
Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/microbiologia , Staphylococcus aureus/patogenicidade , Antibacterianos/uso terapêutico , Bacteriemia/diagnóstico , Bacteriemia/tratamento farmacológico , Pré-Escolar , Humanos , Veias Jugulares/diagnóstico por imagem , Síndrome de Lemierre/tratamento farmacológico , Masculino , Meticilina/farmacologia , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/isolamento & purificação , Resultado do Tratamento , Ultrassonografia
3.
Vascular ; 28(4): 485-488, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32228176

RESUMO

BACKGROUND: Lemierre's syndrome is a rare but potentially fatal condition. The course is characterized by acute tonsillopharyngitis, bacteremia, internal jugular vein thrombosis, and septic embolization. There have been some cases secondary to penetrating trauma to the neck. Literature review has yielded no cases secondary to blunt neck trauma in the absence of oropharyngeal injury. We aim to shed light on this unique cause of Lemierre's syndrome, so as to raise the index of suspicion for clinicians working up patients with blunt cervical trauma. METHODS: We present a case of a 25-year-old male restrained driver who presented with left neck and shoulder pain with a superficial abrasion to the left neck from the seatbelt who was discharged same day by the Emergency Room physicians. He returned to the Emergency Department two days later with abdominal pain. As a part of his repeat evaluation, a set of blood cultures were sent and was sent home that day. The patient was called back to the hospital one day later as preliminary blood cultures were positive for Gram positive cocci and Gram negative anaerobes. Computerized tomography scan of the neck revealed extensive occlusive left internal jugular vein thrombosis and fluid collections concerning for abscesses, concerning for septic thrombophlebitis. The patient continued to decompensate, developing severe sepsis complicated by disseminated intravascular coagulation. RESULTS: The patient underwent a left neck exploration with en bloc resection of the left internal jugular vein, drainage of abscesses deep to the sternocleidomastoid, and washout/debridement of necrotic tissue. Direct laryngoscopy at the time of surgery revealed no injury to the aerodigestive tract. Wound cultures were consistent with blood cultures and grew Fusobacterium necrophorum, Staphylococcus epidermidis, and Methicillin-resistant staphylococcus aureus. The patient underwent two subsequent operative wound explorations without any evidence of residual infection. The patient was discharged home on postoperative day 13 on a course of antibiotics and aspirin. CONCLUSION: This case illustrates the importance of diagnosis of Lemierre's syndrome after an unconventional inciting event (blunt cervical trauma) and appropriate treatment.


Assuntos
Acidentes de Trânsito , Síndrome de Lemierre/microbiologia , Lesões do Pescoço/etiologia , Sepse/microbiologia , Lesões do Ombro/etiologia , Ferimentos não Penetrantes/etiologia , Adulto , Antibacterianos/administração & dosagem , Desbridamento , Coagulação Intravascular Disseminada/microbiologia , Drenagem , Humanos , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/terapia , Masculino , Lesões do Pescoço/diagnóstico , Sepse/diagnóstico , Sepse/terapia , Lesões do Ombro/diagnóstico , Resultado do Tratamento , Ferimentos não Penetrantes/diagnóstico
5.
J Investig Med High Impact Case Rep ; 7: 2324709619890967, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31795752

RESUMO

Lemierre's syndrome is an uncommon and potentially fatal complication of oropharyngeal and facial infections. It involves an associated septic thrombophlebitis, bacteremia, and septic emboli. Traditionally, compromise of the internal jugular vein has been described in conjunction with an infection caused by anaerobes, especially, Fusobacterium necrophorum. In recent years, however, variant forms have been appearing, including other vessel compromise and other etiologic agents. We present the case of Lemierre's syndrome in a 31-year-old male with facial vein thrombosis, septic emboli to the lungs, and bacteremia caused by methicillin-resistant Staphylococcus aureus. We hope that this case will raise awareness about variant presentations and promote a timely diagnosis and appropriate treatment of this potentially fatal infection.


Assuntos
Bacteriemia/microbiologia , Veias Jugulares , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/microbiologia , Staphylococcus aureus Resistente à Meticilina , Adulto , Antibacterianos/uso terapêutico , Bacteriemia/diagnóstico , Bacteriemia/tratamento farmacológico , Humanos , Síndrome de Lemierre/tratamento farmacológico , Masculino , Radiografia Torácica , Tomografia Computadorizada por Raios X
6.
Recenti Prog Med ; 110(11): 543-547, 2019 Nov.
Artigo em Italiano | MEDLINE | ID: mdl-31808441

RESUMO

A healthy 16-year-old boy was hospitalized for fever, septic condition and thrombosis of the left internal jugular vein: The diagnosis of Lemierre syndrome (LS) with positive blood culture for Fusobacterium necrophorum was formalized. He was treated with antibiotics and anticoagulant therapy with enoxaparin with complete recovery. Four weeks after discharge, the jugular vein ecodoppler showed complete resolution of the thrombosis. LS is characterized by thrombosis of the internal jugular vein and anaerobic bacteremia often caused by Fusobacterium necrophorum. It is a rare disease in the post-antibiotic era, but with an increase in cases over the last twenty years. LS should be suspected in young, healthy patients with persistent pharyngitis followed by sepsis, pneumonia or atypical laterocervical pain. The diagnosis is confirmed by the identification of jugular venous thrombosis and is further confirmed by the growth of anaerobic bacteria on blood culture. Prolonged antibiotic and anticoagulant therapies are the essential elements of treatment. However, anticoagulant therapy for internal venous thrombosis associated with LS remains a controversy.


Assuntos
Veias Jugulares , Síndrome de Lemierre/complicações , Trombose Venosa/etiologia , Adolescente , Fusobacterium necrophorum/isolamento & purificação , Humanos , Veias Jugulares/diagnóstico por imagem , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/tratamento farmacológico , Síndrome de Lemierre/epidemiologia , Masculino , Avaliação de Sintomas , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/microbiologia
7.
Pediatr. aten. prim ; 21(83): e145-e149, jul.-sept. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-188646

RESUMO

El síndrome de Lemierre es una patología poco frecuente y potencialmente letal, que se origina como complicación de una infección localizada a nivel de cabeza y cuello que se extiende al espacio carotídeo. Se asocia a tromboflebitis séptica de la vena yugular interna y con frecuencia produce embolias sépticas a distancia. Se presenta generalmente como un cuadro de fiebre y odinofagia de varios días de evolución tras el antecedente de una infección orofaríngea aparentemente resuelta. Otros focos infecciosos menos frecuentes pueden corresponder a mastoiditis, sinusitis u otitis media aguda. El diagnóstico es fundamentalmente clínico y apoyado en las pruebas de imagen, como la ecografía Doppler y la tomografía computarizada cervical con contraste. El tratamiento consiste en antibioterapia prolongada con adecuada cobertura para anaerobios, especialmente Fusobacterium necrophorum, el patógeno más frecuente. El papel de la anticoagulación en el síndrome de Lemierre es controvertido. Se presenta un caso de síndrome de Lemierre secundario a una otitis media aguda


Lemierre's syndrome is a rare and potentially lethal disease that originates as a complication of a localized infection at the head and neck level that extends to the carotid space. It is associated with septic thrombophlebitis of the internal jugular vein and often produces septic emboli at a distance. It usually presents as a picture of fever and odynophagia several days after the history of an apparently resolved oropharyngeal infection. Other less frequent infectious foci may correspond to mastoiditis, sinusitis or acute otitis media. The diagnosis is fundamentally clinical and supported by imaging tests such as Doppler ultrasound and cervical CT with contrast. The treatment consists of prolonged antibiotic therapy with adequate coverage for anaerobes, especially Fusobacterium necrophorum, which is the most frequent pathogen. The role of anticoagulation in Lemierre's syndrome is controversial. We present a case of Lemierre's syndrome secondary to acute otitis media


Assuntos
Humanos , Feminino , Adolescente , Síndrome de Lemierre/diagnóstico , Otite Média/complicações , Tromboflebite/complicações , Antibacterianos/uso terapêutico , Celulite (Flegmão)/diagnóstico , Streptococcus intermedius/isolamento & purificação , Diagnóstico Diferencial , Embolia/diagnóstico , Mastoidite/diagnóstico , Veias Jugulares/fisiopatologia , Adenoma/diagnóstico , Infecções Estreptocócicas/diagnóstico
8.
ORL J Otorhinolaryngol Relat Spec ; 81(4): 234-239, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31315119

RESUMO

Lemierre's syndrome is an infrequent disease characterized by septic thrombosis of the internal jugular vein followed by pulmonary embolism generally occurring after upper respiratory and gastrointestinal tract infections. We present the case of a 15-year-old female patient with postseptal cellulitis and cervical abscess who developed pulmonary embolism and pleural effusion secondary to internal jugular vein thrombosis. Cultures were positive for Streptococcus anginosus, antibiotic treatment was established with satisfactory clinical outcome. High clinical suspicion is required for a diagnosis. The mainstay of treatment is a multidisciplinary approach based on two essential pillars: antibiotic therapy and surgical drainage. This is an important case because of the unusual presentation, the isolation of an infrequent pathogen, and the primary infection site (postseptal cellulitis), which are rare characteristics of this condition in the pediatric population.


Assuntos
Celulite (Flegmão)/diagnóstico , Síndrome de Lemierre/etiologia , Doenças Orbitárias/diagnóstico , Infecções Estreptocócicas/complicações , Streptococcus anginosus/isolamento & purificação , Adolescente , Antibacterianos/uso terapêutico , Celulite (Flegmão)/microbiologia , Celulite (Flegmão)/terapia , Diagnóstico Diferencial , Drenagem , Feminino , Humanos , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/microbiologia , Imagem por Ressonância Magnética , Doenças Orbitárias/microbiologia , Doenças Orbitárias/cirurgia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Tomografia Computadorizada por Raios X
9.
BMJ Case Rep ; 12(4)2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-31015242

RESUMO

Lemierre's syndrome is a potentially severe disease characterised by suppurative thrombophlebitis of the internal jugular vein and subsequent disseminated septic embolisation. The profile of this syndrome declined in the mid-20th century, coinciding with the introduction of antibiotics. Currently, lack of awareness of this condition delays appropriate treatment and worsens prognosis. We report a case of Lemierre's syndrome in a 12-year-old girl.


Assuntos
Veias Jugulares/patologia , Síndrome de Lemierre/diagnóstico , Tromboflebite/complicações , Administração Intravenosa , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Conscientização , Criança , Embolia/diagnóstico por imagem , Embolia/tratamento farmacológico , Embolia/microbiologia , Feminino , Fusobacterium necrophorum/isolamento & purificação , Humanos , Veias Jugulares/diagnóstico por imagem , Síndrome de Lemierre/tratamento farmacológico , Síndrome de Lemierre/microbiologia , Síndrome de Lemierre/patologia , Doenças Raras , Tomografia Computadorizada por Raios X , Tonsilectomia/métodos , Resultado do Tratamento , Ultrassonografia Doppler
11.
BMJ Case Rep ; 12(1)2019 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-30700448

RESUMO

Fusobacterium necrophorum is a rare infection most notable for causing Lemierre's syndrome. This consists of a primary oropharyngeal infection and septic thrombophlebitis, and one or more metastatic focus. Prior to the widespread use of antibiotics, Lemierre's syndrome commonly followed a rapidly progressing course, with a high mortality. We describe a case of a previously well 18-month-old boy who presented to the emergency department with a 3-week history of progressive, right-sided, painful neck swelling and systemic sepsis. He was initially treated conservatively with intravenous antibiotics, but ultimately required surgical drainage. Lemierre's syndrome is a rare condition with increasing incidence which can have significant adverse outcomes including death. Early recognition and treatment are essential, but identifying Lemierre's disease is challenging.


Assuntos
Fusobacterium necrophorum/isolamento & purificação , Síndrome de Lemierre/complicações , Síndrome de Lemierre/diagnóstico , Faringite/complicações , Faringite/tratamento farmacológico , Sepse/complicações , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Cavidades Cranianas/diagnóstico por imagem , Cavidades Cranianas/microbiologia , Diagnóstico Diferencial , Drenagem , Humanos , Lactente , Veias Jugulares/diagnóstico por imagem , Veias Jugulares/microbiologia , Síndrome de Lemierre/tratamento farmacológico , Masculino , Pescoço/diagnóstico por imagem , Pescoço/microbiologia , Radiografia Intervencionista , Sepse/diagnóstico , Sepse/tratamento farmacológico , Tomografia Computadorizada por Raios X , Tonsilite/complicações , Tonsilite/tratamento farmacológico , Resultado do Tratamento , Ultrassonografia
12.
BMJ Case Rep ; 12(1)2019 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-30709834

RESUMO

Infections caused by fusobacteria have a wide clinical spectrum, and in certain patients, they can lead to severe systemic illness. We report the case of an immunocompromised young woman who presented with severe pneumonia complicated by parapneumonic pleural effusion, despite wide-spectrum antibiotic treatment. Fusobacterium necrophorum was isolated in the samples obtained after thoracentesis was performed. Apart from the pulmonary involvement, we could not identify the infectious focus, since the patient did not have poor dentition or Lemierre's syndrome. After an extended antibiotic regimen and placement of a chest tube, the patient fully recovered and was able to be discharged.


Assuntos
Empiema Pleural/complicações , Infecções por Fusobacterium/complicações , Imunocompetência , Derrame Pleural/complicações , Pneumonia/complicações , Adulto , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Empiema Pleural/diagnóstico , Empiema Pleural/tratamento farmacológico , Feminino , Infecções por Fusobacterium/diagnóstico , Infecções por Fusobacterium/tratamento farmacológico , Fusobacterium necrophorum/isolamento & purificação , Humanos , Síndrome de Lemierre/diagnóstico , Meropeném/uso terapêutico , Derrame Pleural/diagnóstico , Pneumonia/diagnóstico , Pneumonia/tratamento farmacológico , Resultado do Tratamento
13.
Emerg Med Clin North Am ; 37(1): 95-107, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30454783

RESUMO

Infection of the neck is a relatively common emergency department complaint. If not diagnosed and managed promptly, it may quickly progress to a life-threatening infection. These infections can result in true airway emergencies that may require fiberoptic or surgical airways. This article covers common, as well as rare but emergent, presentations and uses an evidence-based approach to discuss diagnostic and treatment modalities.


Assuntos
Infecções/diagnóstico , Pescoço , Emergências , Epiglotite/diagnóstico , Epiglotite/terapia , Humanos , Infecções/terapia , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/terapia , Angina de Ludwig/diagnóstico , Angina de Ludwig/terapia , Mediastinite/diagnóstico , Mediastinite/terapia , Parotidite/diagnóstico , Parotidite/terapia , Abscesso Peritonsilar/diagnóstico , Abscesso Peritonsilar/terapia , Faringite/diagnóstico , Faringite/terapia , Abscesso Retrofaríngeo/diagnóstico , Abscesso Retrofaríngeo/terapia
16.
Ann R Coll Surg Engl ; 101(2): e52-e54, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30372118

RESUMO

Lemierre's syndrome is also known as the forgotten disease, and is a rare but life-threatening complication that can arise after surgical extractions of infected mandibular third molars. Owing to its rarity, oral and maxillofacial surgeons might not immediately recognise or can underestimate the pathological signs, and consequently do not apply the appropriate therapy to treat the syndrome. Here, we report on the occurrence and management of a case of Lemierre's syndrome, where the complications affected the right sigmoid sinus. Since the condition appear to be underreported and not properly highlighted, eventual systematic review and meta-analysis of the occurrence of the Lemierre's syndrome are highly recommended.


Assuntos
Síndrome de Lemierre/diagnóstico , Dente Serotino/cirurgia , Complicações Pós-Operatórias/diagnóstico , Extração Dentária , Adulto , Feminino , Humanos , Síndrome de Lemierre/etiologia
17.
J Clin Pharm Ther ; 44(1): 122-124, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30484880

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Lemierre's syndrome is often misdiagnosed as a common cold or viral infection. Fusobacterium necrophorum is the most common causative organism. The recommended treatment regimen is 6 weeks of a beta-lactam antibiotic along with metronidazole. CASE DESCRIPTION: We present two cases of Lemierre's syndrome with internal jugular vein thrombophlebitis and positive blood cultures for F. necrophorum. The first case was successfully treated with 6 weeks of a beta-lactam antibiotic and 4 weeks of metronidazole, while the second case was successfully treated with 4 weeks of a beta-lactam antibiotic and 2 weeks of metronidazole. WHAT IS NEW AND CONCLUSION: Two cases of Lemierre's syndrome were treated successfully with only 2-4 weeks of metronidazole therapy. Shorter duration of metronidazole therapy should be explored in future studies.


Assuntos
Antibacterianos/administração & dosagem , Infecções por Fusobacterium/diagnóstico , Síndrome de Lemierre/diagnóstico , Tromboflebite/etiologia , Adulto , Feminino , Infecções por Fusobacterium/tratamento farmacológico , Infecções por Fusobacterium/microbiologia , Fusobacterium necrophorum/isolamento & purificação , Humanos , Veias Jugulares/patologia , Síndrome de Lemierre/tratamento farmacológico , Síndrome de Lemierre/microbiologia , Masculino , Metronidazol/administração & dosagem , Doenças Raras/diagnóstico , Doenças Raras/tratamento farmacológico , Doenças Raras/microbiologia , Tromboflebite/microbiologia , beta-Lactamas/administração & dosagem
18.
Hamostaseologie ; 39(1): 76-86, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30071559

RESUMO

Lemierre syndrome usually affects otherwise healthy adolescents or young adults and occurs at an overall rate of 1 to 10 cases per million person-years with an estimated fatality rate of 4 to 9%. Diagnostic criteria remain debated and include acute neck/head bacterial infection (often tonsillitis caused by anaerobes at high potential for sepsis and vascular invasion, notably Fusobacterium necrophorum) complicated by local vein thrombosis, usually involving the internal jugular vein, and systemic septic embolism. Medical treatment is based on antibiotic therapy with anaerobic coverage, anticoagulant drugs and supportive care in case of sepsis. Surgical procedures can be required, including drainage of the abscesses, tissue debridement and jugular vein ligation. Evidence for clinical management is extremely poor in the absence of any adequately sized study with clinical outcomes. In this article, we illustrate two cases of Lemierre syndrome not caused by Fusobacterium necrophorum and provide a clinically oriented discussion on the main issues on epidemiology, pathophysiology and management strategies of this disorder. Finally, we summarize the study protocol of a proposed systematic review and individual patient data meta-analysis of the literature. Our ongoing work aims to investigate the risk of new thromboembolic events, major bleeding or death in patients diagnosed with Lemierre syndrome, and to better elucidate the role of anticoagulant therapy in this setting. This effort represents the starting point for an evidence-based treatment of Lemierre syndrome built on multinational interdisciplinary collaborative studies.


Assuntos
Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/terapia , Adulto , Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Fusobacterium necrophorum/isolamento & purificação , Humanos , Síndrome de Lemierre/complicações , Síndrome de Lemierre/microbiologia , Masculino , Prognóstico , Trombose Venosa/complicações , Trombose Venosa/tratamento farmacológico , Adulto Jovem
19.
BMJ Case Rep ; 11(1)2018 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-30567118

RESUMO

A young previously healthy patient presented with sepsis and cavitating pneumonia. Campylobacter rectus was isolated from blood cultures and subsequent CT neck showed an internal jugular vein thrombosis. Treatment was with antibiotics, anticoagulation and supportive management. Lemierre's syndrome is an infectious thrombophlebitis of the internal jugular vein. Although a rare diagnosis since the use of penicillin for treatment of acute pharyngitis, it is being reported with increasing frequency. Usually associated with Fusobacterium spp, we believe that this is the first reported case of Lemierre's caused by C. rectus-an anaerobic member of the human oral cavity flora, usually associated with localised periodontal disease. The bacillus was isolated from blood during the acute presentation.


Assuntos
Síndrome de Lemierre/diagnóstico , Pneumonia/microbiologia , Tromboflebite/tratamento farmacológico , Doença Aguda , Adulto , Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Campylobacter rectus/isolamento & purificação , Angiografia por Tomografia Computadorizada/métodos , Diagnóstico Diferencial , Humanos , Veias Jugulares/diagnóstico por imagem , Veias Jugulares/patologia , Síndrome de Lemierre/complicações , Síndrome de Lemierre/tratamento farmacológico , Síndrome de Lemierre/patologia , Masculino , Penicilinas/uso terapêutico , Faringite/tratamento farmacológico , Pneumonia/sangue , Pneumonia/diagnóstico por imagem , Pneumonia/tratamento farmacológico , Sepse , Tromboflebite/patologia , Tromboflebite/prevenção & controle , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Trombose Venosa/patologia
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