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Lemierre Syndrome

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141. Mastoiditis (Overview)

. Masked mastoiditis. Laryngoscope . 1983 Aug. 93(8):1034-7. . Oestreicher-Kedem Y, Raveh E, Kornreich L, et al. Complications of mastoiditis in children at the onset of a new millennium. Ann Otol Rhinol Laryngol . 2005 Feb. 114(2):147-52. . Fischer JB, Prout A, Blackwood RA, Warrier K. Lemierre Syndrome Presenting as Acute Mastoiditis in a 2-Year-Old Girl with Congenital Dwarfism. Infect Dis Rep . 2015 Apr 15. 7 (2):5922. . Enoksson F, Groth A, Hultcrantz M, Stalfors J, Stenfeldt K, Hermansson (...) material on this website is protected by copyright, Copyright © 1994-2019 by WebMD LLC. This website also contains material copyrighted by 3rd parties. Close encoded search term (Pediatric Mastoiditis) and Pediatric Mastoiditis What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow Most Popular Articles According to Pediatricians Recommended 2002 994656-overview Diseases & Conditions Diseases & Conditions 2002 858990-overview Procedures

2014 eMedicine Pediatrics

142. Pharyngitis (Diagnosis)

, Fusobacterium necrophorum causes at least 10% of cases of pharyngitis. The study also observed that F. necrophorum was the primary cause of Lemierre syndrome in this age group. [ , ] Viruses that may cause acute viral pharyngitis include the following: EBV (mononucleosis) - Produces a shaggy white membrane Rhinovirus Adenovirus Parainfluenza virus Coxsackievirus Coronavirus Echovirus Cytomegalovirus (CMV) Causes of chronic pharyngitis (usually noninfectious) include the following: Irritation from postnasal (...) Indicate Serious Illness. Medscape Medical News. Available at . Accessed: May 26, 2015. American Academy of Pediatrics. Report of the committee on infectious diseases. Pickering LK, Baker CJ, McMillan J, Long S (Editors). Red Book . . 27th Edition. Elk Grove Village, Il: American Academy of Pediatrics; 2006:430-439.: [Guideline] Ayanruoh S, Waseem M, Quee F, Humphrey A, Reynolds T. Impact of rapid streptococcal test on antibiotic use in a pediatric emergency department. Pediatr Emerg Care . 2009 Nov

2014 eMedicine Pediatrics

143. Pleural Effusion (Diagnosis)

(previously, P carinii ) infection in children with acquired immunodeficiency syndrome (AIDS) can be associated with pleural effusion, with an incidence of about 5%. [ ] Pleural effusion occurs in 2-38% of all cases of pulmonary tuberculosis in children. [ ] Tuberculous pleural effusions can be either primary or the result of reactivation disease. Primary tuberculous pleural effusion results from direct hematogenous invasion of the pleural space by Mycobacterium tuberculosis ; it is usually unilateral (...) include hypoalbuminemia, nephrosis, hepatic cirrhosis, and iatrogenic causes (eg, a misplaced central line or a complication of ventriculopleural shunt). Other, rare causes of pleural effusion include pancreatitis (effusions are usually hemorrhagic, unilateral and left sided), rupture of a pulmonary hydatid cyst into the pleural space, and Lemierre syndrome (postpharyngitis anaerobic sepsis with thrombophlebitis of the internal jugular vein). Previous Next: Epidemiology Parapneumonic effusions

2014 eMedicine Pediatrics

144. Mastoiditis (Diagnosis)

. Masked mastoiditis. Laryngoscope . 1983 Aug. 93(8):1034-7. . Oestreicher-Kedem Y, Raveh E, Kornreich L, et al. Complications of mastoiditis in children at the onset of a new millennium. Ann Otol Rhinol Laryngol . 2005 Feb. 114(2):147-52. . Fischer JB, Prout A, Blackwood RA, Warrier K. Lemierre Syndrome Presenting as Acute Mastoiditis in a 2-Year-Old Girl with Congenital Dwarfism. Infect Dis Rep . 2015 Apr 15. 7 (2):5922. . Enoksson F, Groth A, Hultcrantz M, Stalfors J, Stenfeldt K, Hermansson (...) material on this website is protected by copyright, Copyright © 1994-2019 by WebMD LLC. This website also contains material copyrighted by 3rd parties. Close encoded search term (Pediatric Mastoiditis) and Pediatric Mastoiditis What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow Most Popular Articles According to Pediatricians Recommended 2002 994656-overview Diseases & Conditions Diseases & Conditions 2002 858990-overview Procedures

2014 eMedicine Pediatrics

145. Peritonsillar Abscess (Treatment)

):23-6. . da Silva PS, Waisberg DR. Internal carotid artery pseudoaneurysm with life-threatening epistaxis as a complication of deep neck space infection. Pediatr Emerg Care . 2011 May. 27 (5):422-4. . Roccia F, Pecorari GC, Oliaro A, Passet E, Rossi P, Nadalin J, et al. Ten years of descending necrotizing mediastinitis: management of 23 cases. J Oral Maxillofac Surg . 2007 Sep. 65 (9):1716-24. . Ehrenfried Berthelsen R, Hein L. [Lemierre's syndrome following peritonsillar abscess]. Ugeskr Laeger (...) On About Membership WebMD Network Editions All material on this website is protected by copyright, Copyright © 1994-2019 by WebMD LLC. This website also contains material copyrighted by 3rd parties. Close encoded search term (Peritonsillar Abscess) and Peritonsillar Abscess What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow Most Popular Articles According to General Surgeons Recommended 2010 iclaprim-1000285 Drugs Drugs 2001 /viewarticle

2014 eMedicine Surgery

146. Internal Jugular Vein Thrombosis (Treatment)

, and axillary deep venous thrombosis and the risk of pulmonary embolism. Vascular . 2008 Mar-Apr. 16 (2):73-9. . Righini CA, Karkas A, Tourniaire R, N'Gouan JM, Schmerber S, Reyt E, et al. Lemierre syndrome: study of 11 cases and literature review. Head Neck . 2014 Jul. 36 (7):1044-51. . Ascher E, Salles-Cunha S, Hingorani A. Morbidity and mortality associated with internal jugular vein thromboses. Vasc Endovascular Surg . 2005 Jul-Aug. 39 (4):335-9. . Tovi F, Fliss DM, Gatot A, Hertzanu Y. Septic jugular (...) thrombosis with abscess formation. Ann Otol Rhinol Laryngol . 1991 Aug. 100 (8):682-4. . Fuhrman T, Balatbat J, Frakes J, Metz R. Internal jugular thrombosis causing increased intracranial pressure and upper airway edema. Internet J Anesthesiol . 1999. 4 (3):1-5. . Kim BY, Yoon DY, Kim HC, Kim ES, Baek S, Lim KJ, et al. Thrombophlebitis of the internal jugular vein (Lemierre syndrome): clinical and CT findings. Acta Radiol . 2013 Jul. 54 (6):622-7. . Sheikh MA, Topoulos AP, Deitcher SR. Isolated internal

2014 eMedicine Surgery

147. Pleural Effusion (Overview)

(previously, P carinii ) infection in children with acquired immunodeficiency syndrome (AIDS) can be associated with pleural effusion, with an incidence of about 5%. [ ] Pleural effusion occurs in 2-38% of all cases of pulmonary tuberculosis in children. [ ] Tuberculous pleural effusions can be either primary or the result of reactivation disease. Primary tuberculous pleural effusion results from direct hematogenous invasion of the pleural space by Mycobacterium tuberculosis ; it is usually unilateral (...) include hypoalbuminemia, nephrosis, hepatic cirrhosis, and iatrogenic causes (eg, a misplaced central line or a complication of ventriculopleural shunt). Other, rare causes of pleural effusion include pancreatitis (effusions are usually hemorrhagic, unilateral and left sided), rupture of a pulmonary hydatid cyst into the pleural space, and Lemierre syndrome (postpharyngitis anaerobic sepsis with thrombophlebitis of the internal jugular vein). Previous Next: Epidemiology Parapneumonic effusions

2014 eMedicine Pediatrics

148. Pharyngitis (Overview)

, Fusobacterium necrophorum causes at least 10% of cases of pharyngitis. The study also observed that F. necrophorum was the primary cause of Lemierre syndrome in this age group. [ , ] Viruses that may cause acute viral pharyngitis include the following: EBV (mononucleosis) - Produces a shaggy white membrane Rhinovirus Adenovirus Parainfluenza virus Coxsackievirus Coronavirus Echovirus Cytomegalovirus (CMV) Causes of chronic pharyngitis (usually noninfectious) include the following: Irritation from postnasal (...) Indicate Serious Illness. Medscape Medical News. Available at . Accessed: May 26, 2015. American Academy of Pediatrics. Report of the committee on infectious diseases. Pickering LK, Baker CJ, McMillan J, Long S (Editors). Red Book . . 27th Edition. Elk Grove Village, Il: American Academy of Pediatrics; 2006:430-439.: [Guideline] Ayanruoh S, Waseem M, Quee F, Humphrey A, Reynolds T. Impact of rapid streptococcal test on antibiotic use in a pediatric emergency department. Pediatr Emerg Care . 2009 Nov

2014 eMedicine Pediatrics

149. Retropharyngeal Abscess (Overview)

species. Other causative agents include Haemophilus parainfluenzae, Veillonella, Peptostreptococcus, Fusobacterium, and Eikenella species. Mycobacterium tuberculosis, Bartonella henselae , and Coccidia s hould be suspected in patients who may be predisposed (immunosuppressed individuals or recent immigrants), especially if they are not responding to conventional therapies. Finally, another consideration in the evaluation of these patients is the possibility of Lemierre syndrome (septic (...) thrombophlebitis of the internal jugular vein secondary to RPA). This infection is classically associated with Fusobacterium necrophorum , an anaerobic gram-negative rod. [ ] Surgical intervention, with adjunctive medical treatment that includes antibiotic therapy and anticoagulation, may be warranted in complicated RPA secondary to Lemierre syndrome. Previous Next: Epidemiology United States statistics In an analysis of a large national database of pediatric admissions in the United States, [ ] Lander et al

2014 eMedicine Pediatrics

150. Pharyngitis (Follow-up)

. . Lemierre's syndrome, reemergence of a forgotten disease: a case report. Cases J . 2009 Mar 10. 2:6397. . . Tanz RR, Gerber MA, Kabat W, Rippe J, Seshadri R, Shulman ST. Performance of a rapid antigen-detection test and throat culture in community pediatric offices: implications for management of pharyngitis. Pediatrics . 2009 Feb. 123(2):437-44. . Cohen JF, Cohen R, Bidet P, et al. Efficiency of a clinical prediction model for selective rapid testing in children with pharyngitis: A prospective (...) to disclose. What would you like to print? What would you like to print? Sections Pharyngitis Find Us On About Membership WebMD Network Editions All material on this website is protected by copyright, Copyright © 1994-2019 by WebMD LLC. This website also contains material copyrighted by 3rd parties. Close encoded search term (Pharyngitis) and Pharyngitis What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow Most Popular Articles According

2014 eMedicine Emergency Medicine

151. Pharyngitis (Diagnosis)

. . Lemierre's syndrome, reemergence of a forgotten disease: a case report. Cases J . 2009 Mar 10. 2:6397. . . Tanz RR, Gerber MA, Kabat W, Rippe J, Seshadri R, Shulman ST. Performance of a rapid antigen-detection test and throat culture in community pediatric offices: implications for management of pharyngitis. Pediatrics . 2009 Feb. 123(2):437-44. . Cohen JF, Cohen R, Bidet P, et al. Efficiency of a clinical prediction model for selective rapid testing in children with pharyngitis: A prospective (...) to disclose. What would you like to print? What would you like to print? Sections Pharyngitis Find Us On About Membership WebMD Network Editions All material on this website is protected by copyright, Copyright © 1994-2019 by WebMD LLC. This website also contains material copyrighted by 3rd parties. Close encoded search term (Pharyngitis) and Pharyngitis What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow Most Popular Articles According

2014 eMedicine Emergency Medicine

152. Retropharyngeal Abscess (Diagnosis)

species. Other causative agents include Haemophilus parainfluenzae, Veillonella, Peptostreptococcus, Fusobacterium, and Eikenella species. Mycobacterium tuberculosis, Bartonella henselae , and Coccidia s hould be suspected in patients who may be predisposed (immunosuppressed individuals or recent immigrants), especially if they are not responding to conventional therapies. Finally, another consideration in the evaluation of these patients is the possibility of Lemierre syndrome (septic (...) thrombophlebitis of the internal jugular vein secondary to RPA). This infection is classically associated with Fusobacterium necrophorum , an anaerobic gram-negative rod. [ ] Surgical intervention, with adjunctive medical treatment that includes antibiotic therapy and anticoagulation, may be warranted in complicated RPA secondary to Lemierre syndrome. Previous Next: Epidemiology United States statistics In an analysis of a large national database of pediatric admissions in the United States, [ ] Lander et al

2014 eMedicine Pediatrics

153. Peritonsillar Abscess (Follow-up)

factors may reduce its occurrence. Previous Next: Complications Note the following possible complications: Airway compromise Aspiration of abscess contents (spontaneously or with incision and drainage) and development of aspiration pneumonia Parapharyngeal abscess Septic thrombophlebitis involving the internal jugular vein (Lemierre syndrome) or internal carotid artery leading to septicemia with metastatic foci of infection, especially in the lung (Lemierre syndrome, caused by Fusobacterium ) Carotid (...) on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow Most Popular Articles According to Pediatricians Recommended 2002 858001-overview Procedures Procedures 2002 849233-overview Procedures Procedures 2001 /viewarticle/889211 Journal Article Journal Article 2001 /viewarticle/908860 News News Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult.

2014 eMedicine Pediatrics

154. Infections of the Lung, Pleura and Mediastinum: Surgical Perspective (Diagnosis)

contains fat and lymphoid tissue. The middle mediastinum comprises the heart, pericardium, aorta, carina, mainstem bronchi, and lymph nodes. The posterior mediastinum includes the esophagus, descending aorta, vagus nerve, and thoracic duct. Chest radiographs and computed tomography images of patients with mediastinitis follow. CT scan of the thorax of a sixteen-year-old with Lemierre's syndrome and anterior mediastinitis revealing pneumomediastinum posterior to and to the left of the trachea, free (...) fluid surrounding the trachea, and left pleural effusion. CT scan of the thorax with intravenous contrast of a sixteen-year-old with Lemierre's syndrome and anterior mediastinitis revealing development of ring-enhancing fluid collections in the anterior mediastinum just posterior to the sternum. CT scan of the thorax with intravenous contrast of a sixteen-year-old with Lemierre's syndrome and anterior mediastinitis revealing a right pleural ring-enhancing abscess which persisted following drainage

2014 eMedicine Pediatrics

155. Peritonsillar Abscess (Follow-up)

):23-6. . da Silva PS, Waisberg DR. Internal carotid artery pseudoaneurysm with life-threatening epistaxis as a complication of deep neck space infection. Pediatr Emerg Care . 2011 May. 27 (5):422-4. . Roccia F, Pecorari GC, Oliaro A, Passet E, Rossi P, Nadalin J, et al. Ten years of descending necrotizing mediastinitis: management of 23 cases. J Oral Maxillofac Surg . 2007 Sep. 65 (9):1716-24. . Ehrenfried Berthelsen R, Hein L. [Lemierre's syndrome following peritonsillar abscess]. Ugeskr Laeger (...) On About Membership WebMD Network Editions All material on this website is protected by copyright, Copyright © 1994-2019 by WebMD LLC. This website also contains material copyrighted by 3rd parties. Close encoded search term (Peritonsillar Abscess) and Peritonsillar Abscess What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow Most Popular Articles According to General Surgeons Recommended 2010 iclaprim-1000285 Drugs Drugs 2001 /viewarticle

2014 eMedicine Surgery

156. Peritonsillar Abscess (Overview)

are available internationally. Although tonsillitis is a disease of childhood, only one third of PTA cases are found in this age group. The age of patients with the condition is variable, ranging from 1 to 76 years, with the highest incidence in persons aged 15-35 years. No sexual or racial predilection has been established. In a retrospective cohort study of 427 patients with PTA, Marom et al investigated how the characteristics of PTA may have changed over time. [ ] The results led the authors to conclude (...) A, Passet E, Rossi P, Nadalin J, et al. Ten years of descending necrotizing mediastinitis: management of 23 cases. J Oral Maxillofac Surg . 2007 Sep. 65 (9):1716-24. . Ehrenfried Berthelsen R, Hein L. [Lemierre's syndrome following peritonsillar abscess]. Ugeskr Laeger . 2012 May 28. 174 (22):1534-5. . Ramirez-Schrempp D, Dorfman DH, Baker WE, Liteplo AS. Ultrasound soft-tissue applications in the pediatric emergency department: to drain or not to drain?. Pediatr Emerg Care . 2009 Jan. 25 (1):44-8

2014 eMedicine Surgery

157. Internal Jugular Vein Thrombosis (Follow-up)

, and axillary deep venous thrombosis and the risk of pulmonary embolism. Vascular . 2008 Mar-Apr. 16 (2):73-9. . Righini CA, Karkas A, Tourniaire R, N'Gouan JM, Schmerber S, Reyt E, et al. Lemierre syndrome: study of 11 cases and literature review. Head Neck . 2014 Jul. 36 (7):1044-51. . Ascher E, Salles-Cunha S, Hingorani A. Morbidity and mortality associated with internal jugular vein thromboses. Vasc Endovascular Surg . 2005 Jul-Aug. 39 (4):335-9. . Tovi F, Fliss DM, Gatot A, Hertzanu Y. Septic jugular (...) thrombosis with abscess formation. Ann Otol Rhinol Laryngol . 1991 Aug. 100 (8):682-4. . Fuhrman T, Balatbat J, Frakes J, Metz R. Internal jugular thrombosis causing increased intracranial pressure and upper airway edema. Internet J Anesthesiol . 1999. 4 (3):1-5. . Kim BY, Yoon DY, Kim HC, Kim ES, Baek S, Lim KJ, et al. Thrombophlebitis of the internal jugular vein (Lemierre syndrome): clinical and CT findings. Acta Radiol . 2013 Jul. 54 (6):622-7. . Sheikh MA, Topoulos AP, Deitcher SR. Isolated internal

2014 eMedicine Surgery

158. Thrombophlebitis, Septic (Diagnosis)

increased in elderly persons, likely secondary to concomitant illnesses and a nonspecific, age-related decline in immunologic function. Garrison et al reported increased risk for the development of major complications from intravenous catheter placement in patients aged 50 years and older, with an odds ratio of 4.7. [ ] Notable exceptions to the above age-related predispositions are Lemierre syndrome and septic pelvic and ovarian thrombophlebitides: Lemierre disease occurs in healthy, young adults (...) nutrition. [ ] Patients are generally very ill appearing with high fever, and they may also have signs of venous occlusion, including arm and neck edema. The mortality rate of these infections is high, but cases of successful treatment have been reported. [ ] Lemierre syndrome is a suppurative thrombophlebitis of the internal jugular vein caused by oropharyngeal infections such as tonsillitis and dental infections. Spread of the infection into the parapharyngeal space that houses the carotid sheath

2014 eMedicine Emergency Medicine

159. Thrombophlebitis, Septic (Overview)

secondary to concomitant illnesses and a nonspecific, age-related decline in immunologic function. Garrison et al reported increased risk for the development of major complications from intravenous catheter placement in patients aged 50 years and older, with an odds ratio of 4.7. [ ] Notable exceptions to the above age-related predispositions are Lemierre syndrome and septic pelvic and ovarian thrombophlebitides: Lemierre disease occurs in healthy, young adults with a mean age of onset of 20 years (...) are generally very ill appearing with high fever, and they may also have signs of venous occlusion, including arm and neck edema. The mortality rate of these infections is high, but cases of successful treatment have been reported. [ ] Lemierre syndrome is a suppurative thrombophlebitis of the internal jugular vein caused by oropharyngeal infections such as tonsillitis and dental infections. Spread of the infection into the parapharyngeal space that houses the carotid sheath leads to local inflammation

2014 eMedicine Emergency Medicine

160. Thrombophlebitis, Septic (Follow-up)

in central catheter–associated thrombophlebitis, particularly in patients receiving total parenteral nutrition (TPN), and can usually be covered by the addition of intravenous fluconazole. Anticoagulation is often favored in deep vein disease, although no controlled studies have been performed to date. Studies of central venous thrombophlebitis report success with streptokinase, heparin, and enoxaparin. [ ] Internal jugular thrombophlebitis In the case of Lemierre syndrome, particular attention should (...) ):653-8. . . Verghese A, Widrich WC, Arbeit RD. Central venous septic thrombophlebitis--the role of medical therapy. Medicine (Baltimore) . 1985 Nov. 64(6):394-400. . Sinave CP, Hardy GJ, Fardy PW. The Lemierre syndrome: suppurative thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection. Medicine (Baltimore) . 1989 Mar. 68(2):85-94. . Moore-Gillon J, Lee TH, Eykyn SJ, Phillips I. Necrobacillosis: a forgotten disease. Br Med J (Clin Res Ed) . 1984 May 19. 288(6429):1526-7

2014 eMedicine Emergency Medicine

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