necrobacillosis; Lemierre's disease; postanginal sepsis
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Etiology
- Fusobacterium necrophorum, in conjunction with other bacterial flora
Epidemiology
- more common in adolescents & young adults
Pathology
- infection of the tonsils & pharynx
- may spread to subcutaneous tissues of jaw & neck
Clinical manifestations
- starts as severe exudative pharyngitis
- pain & swelling at the angle of the jaw
- tenderness over the sternocleidomastoid muscle
- symptoms may spread
- fever
- pleuritic chest pain & productive cough (case report)[2]
Laboratory
- anaerobic blood culture
- SaO2 of 88% (case report)[2]
Radiology
- chest X-ray (case report)[2]
- consolidation in the middle & upper lung
- chest CT (case report)[2]
- multiple cavitary lesions
- loculated left pleural effusion
- contrast enhanced CT of neck
- CT pulmonary angiography
computed tomography images[2]
Complications
- septic thrombophlebitis of the internal jugular vein
- septic pulmonary embolism
- death
Management
- drainage of pleural effusion
- intravenous ceftriaxone & oral metronidazole[2]
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Walkty A, EmbilJ. Lemierre's Syndrome. N Engl J Med 2019; 380:e16. March 21. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30893539 https://www.nejm.org/doi/full/10.1056/NEJMicm1808378