1/91. Anaerobic septicaemia by fusobacterium necrophorum: Lemierre's syndrome.Lemierre's syndrome is characterized by acute pharyngotonsillitis with secondary thrombophlebitis of the internal jugular vein which is complicated by multiple metastatic foci of infections. This syndrome is caused by fusobacterium necrophorum in healthy young persons and is extremely rare in occurrence. A pre-school child with Lemierre's syndrome is reported. The diagnostic and therapeutic aspects are emphasized in order to sensitize physicians to this uncommon condition.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/91. lemierre syndrome: magnetic resonance imaging and computed tomographic appearance.lemierre syndrome consists of septic thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection, usually with fusobacterium necrophorum. Septic metastatic emboli and distant infection are characteristic. We describe the imaging appearance of lemierre syndrome in an adolescent female by both magnetic resonance imaging and computed tomography. This case illustrates the rapid onset and characteristic progression of the rare syndrome of Lemierre. In addition, we used magnetic resonance imaging to effectively distinguish between inflammatory venous thrombosis and abscess, thus avoiding surgery in our patient. Early directed antibiotic therapy is mandatory to ensure good outcome.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
3/91. Thoracic complications of lemierre syndrome.lemierre syndrome is a severe, septicemic illness most commonly caused by the anaerobic Gram-negative bacillus fusobacterium necrophorum. It is characterized by an acute oropharyngeal infection, with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. This report of a patient with the lemierre syndrome is complemented by a review of the literature on the subject.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
4/91. Two cases of diskitis attributable to anaerobic bacteria in children.Diskitis, an inflammation of the intervertebral disk, is generally attributable to staphylococcus aureus and rarely staphylococcus epidermidis, kingella kingae, Enterobacteriaciae, and streptococcus pneumoniae. In many cases, no bacterial growth is obtained from infected intervertebral discs. Although anaerobic bacteria were recovered from adults with spondylodiscitis, these organisms were not reported before from children. The recovery of anaerobic bacteria in 2 children with diskitis is reported. Patient 1. A 10-year-old male presented with 6 weeks of low back pain and 2 weeks of low-grade fever and abdominal pain. physical examination was normal except for tenderness to percussion over the spine between thoracic vertebra 11 and lumbar vertebra 2. The patient had a temperature of 104 degrees F. Laboratory tests were within normal limits, except for erythrocyte sedimentation rate (ESR), which was 58 mm/hour. Blood culture showed no growth. magnetic resonance imaging with gadolinium contrast revealed minimal inflammatory changes in the 12th thoracic vertebra/first lumbar vertebra disk. There was no other abnormality. A computed tomography (CT)-guided aspiration of the disk space yielded bloody material, which was sent for aerobic and anaerobic cultures. Gram stain showed numerous white blood cells and gram-positive cocci in chains. Cultures for anaerobic bacteria yielded heavy growth of peptostreptococcus magnus, which was susceptible to penicillin, clindamycin, and vancomycin. The patient was treated with intravenous penicillin 600 000 units every 6 hours for 3 weeks, and then oral amoxicillin, 500 mg every 6 hours for 3 weeks. The back pain resolved within 2 weeks, and the ESR returned to normal at the end of therapy. Follow-up for 3 years showed complete resolution of the infection. Patient 2. An 8-year-old boy presented with low back pain and low-grade fever, irritability, and general malaise for 10 days. He had had an upper respiratory tract infection with sore throat 27 days earlier, for which he received no therapy. The patient had a temperature of 102 degrees F, and physical examination was normal except for tenderness to percussion over the spine between the second and fourth lumbar vertebrae. Laboratory tests were normal, except for the ESR (42 mm/hour). Radiographs of the spine showed narrowing of the third to fourth lumbar vertebra disk space and irregularity of the margins of the vertebral endplates. A CT scan revealed a lytic bone lesion at lumbar vertebra 4, and bone scan showed an increase uptake of (99m)technetium at the third to fourth lumbar vertebra disk space. CT-guided aspiration of the disk space yielded cloudy nonfoul-smelling material, which was sent for aerobic and anaerobic cultures. Gram stain showed numerous white blood cells and fusiform Gram-negative bacilli. Anaerobic culture grew light growth of fusobacterium nucleatum. The organism produced beta-lactamase and was susceptible to ticarcillin-clavulanate, clindamycin, metronidazole, and imipenem. Therapy with clindamycin 450 mg every 8 hours was given parenterally for 3 weeks and orally for 3 weeks. Back pain resolved within 2 weeks. A 2-year follow-up showed complete resolution and no recurrence. This report describes, for the first time, the isolation of anaerobic bacteria from children with diskitis. The lack of their recovery in previous reports and the absence of bacterial growth in over two third of these studies may be caused by the use of improper methods for their collection, transportation, and cultivation. Proper choice of antimicrobial therapy for diskitis can be accomplished only by identification of the causative organisms and its antimicrobial susceptibility. This is of particular importance in infections caused by anaerobic bacteria that are often resistant to antimicrobials used to empirically treat diskitis. This was the case in our second patient, who was infected by F nucleatum, which was resistant to beta-lactam antibiotics. The origin of the anaerobic bacteria causing the infection in our patient is probably of endogenous nature. The presence of abdominal pain in the first child may have been attributable to a subclinical abdominal pathothology. The preceding pharyngitis in the second patient may have been associated with a potential hematogenous spread of F nucleatum. P magnus has been associated with bone and joint infections. This report highlights the importance of obtaining disk space culture for aerobic and anaerobic bacteria from all children with diskitis. Future prospective studies are warranted to elucidate the role of anaerobic bacteria in diskitis in children.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
5/91. Lemierre's syndrome presenting as multiple lung abscesses.Lemierre's syndrome is thrombophlebitis of the internal jugular vein (IJV), complicating an oropharingeal infection. The causative organism is Fusobacterium, an anaerobic bacillus, and the syndrome typically occurs in previously healthy teenagers and young adults. Thromboembolic metastases are a common sequela, and the lungs are most frequently affected. We present a case of a 25-year-old woman, who presented with multiple lung abscesses, in whom IJV thrombophlebitis was subsequently noted.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
6/91. Lemierre's syndrome with spondylitis and pulmonary and gluteal abscesses associated with mycoplasma pneumoniae pneumonia.Lemierre's syndrome, a systemic anaerobic infection caused by fusobacterium necrophorum, is characterized by an acute oropharyngeal infection, septic thrombophlebitis of the internal jugular veins, sepsis, and multiple metastatic infections. It commonly leads to pulmonary parenchymal abscesses and occasionally to septic arthritis, osteomyelitis, or liver or spleen abscesses. Reported here is a case of spondylitis and pulmonary and gluteal abscesses that occurred as part of a classic presentation of Lemierre's syndrome. Treatment with imipenem and clindamycin was successful.- - - - - - - - - - ranking = 3keywords = infection (Clic here for more details about this article) |
7/91. Lemierre's syndrome.This is a case report of Lemierre's syndrome in a 17-year-old male patient. Lemierre's disease consists of suppurative thrombophlebitis of the internal jugular vein (SIJVT) in the presence of oropharyngeal infection and can be complicated by septic pulmonary embolism. Other causes of SIJVT include deep neck infections and central venous catheterization. The disease usually results from Gram-negative anaerobic organisms such as fusobacterium necrophorum.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
8/91. Lemierre's syndrome. sepsis complicating an anaerobic oropharyngeal infection.Previously healthy people without interfering conditions are rarely affected by anaerobic infections. We report a young patient with extended septic emboli in the lungs, after an episode of sore throat, due to anaerobic bacteremia with fusobacterium necrophorum. The first description of oropharyngeal infection complicated by sepsis was given by Lemierre in 1936. knowledge of Lemierre's syndrome should lead to early recognition and prompt action against this sporadic and possible fatal illness.- - - - - - - - - - ranking = 6keywords = infection (Clic here for more details about this article) |
9/91. Lemierre's syndrome.We describe a 32-year-old woman who had temperatures increasing over 7 days from 100.7 degrees F to 104.0 degrees F. She had an upper respiratory infection and swelling of the left side of the neck. She was diagnosed with Lemierre's syndrome.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
10/91. aggressive periodontitis associated with Fanconi's anemia. A case report.BACKGROUND: Fanconi's anemia is an autosomal recessive disease associated with chromosomal breakage as well as pancytopenia, skin pigmentation, renal hypoplasia, cardiac defects, microcephaly, congenital malformations of the skeleton, hypogonadism, and increased risk of leukemia. The present report describes the periodontal clinical and microbiological status of an 11-year old male having Fanconi's anemia. methods: polymerase chain reaction analysis to detect human cytomegalovirus (HCMV), Epstein-Barr type 1 virus, and herpes simplex virus (HSV) was performed on paper-point samples pooled from either 3 periodontal sites with advanced attachment loss or 3 gingivitis sites with no clinical attachment loss. Anaerobic bacterial culture examination was performed on the pooled periodontitis sample. RESULTS: The patient suffered from pancytopenia, allergy, asthma, hearing impairment, and mental retardation. dentition consisted of 7 primary teeth, 11 erupted permanent teeth, and 14 unerupted permanent teeth. Most erupted teeth showed severe gingival inflammation with some gingival overgrowth and various degrees of periodontal attachment loss. Genomes of HCMV and HSV were detected in the pooled periodontitis sample and HCMV in the pooled gingivitis sample. The periodontitis sample but not the gingivitis sample revealed HCMV mRNA of major capsid protein, suggestive of active viral infection. The periodontitis sample also yielded actinobacillus actinomycetemcomitans (1.1% of total isolates), FusobActerium species (7.9%), campylobacter species (2.2%), peptostreptococcus micros (3.4%), and candida albicans (0.3%). CONCLUSIONS: Oral features of Fanconi's anemia may include increased susceptibility to periodontitis. It is likely that underlying host defense impairment coupled with periodontal infection by HCMV and A. actinomycetemcomitans contribute to the severe type of periodontitis associated with Fanconi's anemia.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
| | Next -> |