Forgotten disease: an atypical case of Lemierre syndrome presenting as a soft tissue abscess

2021 ◽  
Vol 14 (6) ◽  
pp. e242468
Author(s):  
Dilpat Kumar ◽  
Wasif Elahi Shamsi ◽  
Thales Gomes ◽  
FNU Warsha
Keyword(s):  
Fusobacterium Nucleatum ◽  
Peritonsillar Abscess ◽  
External Jugular Vein ◽  
Left Shoulder ◽  
Lemierre Syndrome ◽  
Oropharyngeal Infection ◽  
Soft Tissue Abscess ◽  
Lower Neck ◽  
The Right ◽  
Prompt Diagnosis

Lemierre syndrome (LS) is an acute oropharyngeal infection with secondary septic thrombophlebitis and distant septic embolisation. A 29-year-old woman with sore throat, dyspnoea and left shoulder pain, who was on levofloxacin for 3 days, presented with worsening symptoms. She was tachycardic, tachypneic and hypoxic on presentation. CT of neck and chest revealed multiple loculated abscesses on her left lower neck and shoulder, right peritonsillar abscess, thrombosis of the right external jugular vein and multiple bilateral septic emboli to the lungs. She was started on clindamycin and ampicillin sulbactam for LS. She developed septic shock and required intubation due to respiratory failure. Drainage of the left shoulder abscess grew Fusobacterium nucleatum. After 2 weeks of a complicated intensive care unit stay, her haemodynamic status improved and she was transferred to the floor. LS has variable presentations, but regardless of the presentation, it is a potentially fatal disease-requiring prompt diagnosis and management.

scholarly journals Pemetaan Potensi Muskuloskletal Disorders (MSDs) pada Aktivitas Manual Material Handling (MMH) Kelapa Sawit

2017 ◽  
Vol 10 (1) ◽  
Author(s):  
Roberta Zulfhi Surya
Keyword(s):  
Palm Oil ◽  
Material Handling ◽  
Muscle Tension ◽  
Left Shoulder ◽  
Body Parts ◽  
Materials Handling ◽  
Industrial Oil ◽  
Manual Material Handling ◽  
Lower Neck ◽  
The Right

<p>Palm oil (Elaeis) is an important industrial plants producing cooking oil, industrial oil, and fuel (biodiesel) as the palm oil business is currently exceptional. Work activities in palm oil plantations, especially, loading and unloading are potentially causing Musculoskletal Disorders (MSDs). Manual Materials Handling (MMH) activities in palm oil business potentially occurs MSDs at (1) the upper neck; (2) the lower neck; (3) the left shoulder; (4) the right shoulder; (5) the backs; (6) on the right arm; (7) under the left arm; (8) the right forearm; (9) the left wrist; (10) the right wrist; (11) the left hand; and (12) the right hand. MSDs happens due to these 12 body parts are in direct contact with the activities. The primary cause of MSDs is unnatural working attitude and excessive muscle tension began from the design of a working system that is designed not in accordance with the workers’ limitations.</p><p>Keywords: Palm Oil, Musculoskletal Disorders, Manual Material Handling</p>

scholarly journals Descending necrotizing mediastinitis

2006 ◽  
Vol 63 (7) ◽  
pp. 677-680 ◽  
Author(s):  
Vlado Cvijanovic ◽  
Vojkan Stanic ◽  
Aleksandar Ristanovic ◽  
Bojan Gulic ◽  
Savo Durkovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Massive Bleeding ◽  
Peritonsillar Abscess ◽  
Descending Necrotizing Mediastinitis ◽  
Right Thoracotomy ◽  
Oropharyngeal Infection ◽  
Disease Case ◽  
Mediastinal Drainage ◽  
Optimal Approach ◽  
Prompt Diagnosis

Background: Descending necrotizing mediastinitis (DNM) is an acute, serious, septic disease which results from a complication of oropharyngeal infection. The disease requires a prompt diagnosis and radical surgical treatment to reduce high mortality (40%). The optimal form of mediastinal drainage remains controversial. The reason for publishing this report is both the fact that DNM is very rare and our experience preferring thoracotomy as an optimal approach to treating the disease. Case report. We reported a 34-years-old woman with DNM. The disease began as a peritonsillar abscess. After a bilateral double pleural drainage the disease worsened. In order to achieve radical mediastinal debridement and drainage, we carried out posterolateral right thoracotomy. We also had to perform left thoracotomy because of massive bleeding caused by septic erosion. There were no more reoperations. Conclusion. Aggressive surgical treatment, regardless the localization and the extent of changes is the key to success in the treatment of patients with necrotizing mediastinitis.

scholarly journals Lemierre’s Syndrome: A Complication of Cervicofacial Cellulitis in a Child

2021 ◽  
pp. 1-3
Author(s):  
Mohamed Ali GLITI ◽  
◽  
Lina EL Messaoudi ◽  
Sophia Nitassi ◽  
Bencheikh Razika ◽  
...  
Keyword(s):  
Jugular Vein ◽  
Chest Ct ◽  
Blood Cultures ◽  
Septic Thrombophlebitis ◽  
Lemierre’S Syndrome ◽  
Pediatric Case ◽  
Lemierre Syndrome ◽  
Oropharyngeal Infection ◽  
The Right ◽  
Lemierre's Syndrome

Introduction: Lemierre’s syndrome complicates oropharyngeal infection and associates septic thrombophlebitis of the internal jugular vein with sepsis and distant septic emboli (especially pulmonary). We report a pediatric case with thrombophlebitis of the jugular vein in the context of cervicofacial cellulitis. Summary of the Clinical Case: A 2-year-old girl consulted in the emergency room for angina complicated by right cervicofacial cellulitis with thrombosis of the right jugular vein. The diagnosis of atypical Lemierre syndrome was made and the patient received first medical treatment (antibiotic therapy, anticoagulation) allowing a cure without sequelae. And secondary surgical treatment (adenoidectomy and tonsillectomy). Discussion: The presence of a cervical venous thrombosis complicating an oropharyngeal infection should lead to a search for Lemierre’s syndrome (blood cultures and chest CT) rare but serious and require immediate treatment

scholarly journals Sore Throat, Fever, Septic Emboli, and Acute Respiratory Distress Syndrome: A Case of Lemierre Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Farrukh N. Jafri ◽  
Jodi Shulman ◽  
José C. Gómez-Márquez ◽  
Matthew Lazarus ◽  
David M. Ginsburg
Keyword(s):  
Sore Throat ◽  
Distress Syndrome ◽  
Jugular Vein ◽  
Septic Thrombophlebitis ◽  
Chest Discomfort ◽  
Lemierre Syndrome ◽  
Septic Emboli ◽  
Oropharyngeal Infection ◽  
Progression Of Disease ◽  
Prompt Diagnosis

Lemierre’s syndrome is an acute oropharyngeal infection with a secondary septic thrombophlebitis of the internal jugular vein (IVJ) that was first reported in literature in 1936. It involves the progression of disease from a focal suppurative peritonsillar infection to a local septic thrombophlebitis with hematogenous progression to and distant septic emboli. It is a rare and potentially fatal syndrome requiring prompt diagnosis and management. We present the case progression of an 18-year-old male who presented to our hospital with resolved sore throat, fever, and chest discomfort who experienced a sharp clinical decline. His case, physical exam, laboratory abnormalities, and radiologic studies highlight important facets of this rare but important syndrome.

scholarly journals Clinical Study of 107 Hospitalized Patients with Peritonsillar Abscess

2021 ◽  
Vol 04 (01) ◽  
pp. e11-e16
Author(s):  
Risa Wakisaka ◽  
Takumi Kumai ◽  
Kan Kishibe ◽  
Miki Takahara ◽  
Akihiro Katada ◽  
...  
Keyword(s):  
Clinical Study ◽  
Initial Treatment ◽  
Peritonsillar Abscess ◽  
Laryngeal Edema ◽  
Antibacterial Drugs ◽  
Inferior Pole ◽  
Duration Of Hospitalization ◽  
The Right ◽  
Superior Pole

AbstractWe conducted a retrospective analysis of the data of 107 cases of peritonsillar abscess treated at our hospital between January 2014 and December 2018. Data on age, sex, affected site, duration of hospitalization, method of drainage, presence/absence of laryngeal edema, antibacterial drugs used, and isolated bacteria were analyzed. Of the 107 patients, 71 were males and 36 were females; the median age was 44 years (range: 18–88 years).The left side was affected in 55 patients, the right side in 50 patients, and both sides in two patients. The abscess was localized in the superior pole in 71 patients, and in the inferior pole in 36 patients. Thirty-five patients had laryngeal edema, of which three underwent tracheotomy. Recurrence of the abscess was observed in 15 cases, with the recurrence developing within 3 months in 7 cases, and over a period of 3 years in 4 cases. As for the sensitivity of the causative bacteria to antibacterial drugs, 17% of the causative bacteria showed resistance to clindamycin, while none showed resistance to ampicillin/sulbactam (ABPC/SBT). We concluded that ABPC/SBT might be suitable for the initial treatment of peritonsillar abscess, and that we need to bear in mind the possibility of long-term recurrence.

scholarly journals Pursuing Artful Movement Science in Music Performance: Single Subject Motor Analysis With Two Elite Pianists

2021 ◽  
pp. 003151252110034
Author(s):  
Craig Turner ◽  
Peter Visentin ◽  
Deanna Oye ◽  
Scott Rathwell ◽  
Gongbing Shan
Keyword(s):  
Motor Learning ◽  
Music Performance ◽  
Force Plate ◽  
Left Shoulder ◽  
Single Subject ◽  
Performance Variables ◽  
Motor Behaviors ◽  
Piano Students ◽  
Motor Strategy ◽  
The Right

Piano performance motor learning research requires more “artful” methodologies if it is to meaningfully address music performance as a corporeal art. To date, research has been sparse and it has typically constrained multiple performance variables in order to isolate specific phenomena. This approach has denied the fundamental ethos of music performance which, for elite performers, is an act of interpretation, not mere reproduction. Piano performances are intentionally manipulated for artistic expression. We documented motor movements in the complex task of performance of the first six measures of Chopin’s “Revolutionary” Etude by two anthropometrically different elite pianists. We then discussed their motor strategy selections as influenced by anthropometry and the composer’s musical directives. To quantify the joint angles of the trunk, shoulders, elbows, and wrists, we used a VICON 3 D motion capture system and biomechanical modeling. A Kistler force plate (1 N, Swiss) quantified center of gravity (COG) shifts. Changes in COG and trunk angles had considerable influence on the distal segments of the upper limbs. The shorter pianist used an anticipatory strategy, employing larger shifts in COG and trunk angles to produce dynamic stability as compensation for a smaller stature. Both pianists took advantage of low inertial left shoulder internal rotation and adduction to accommodate large leaps in the music. For the right arm, motor strategizing was confounded by rests in the music. These two cases illustrated, in principle, that expert pianists’ individualized motor behaviors can be explained as compensatory efforts to accommodate both musical goals and anthropometric constraints. Motor learning among piano students can benefit from systematic attention to motor strategies that consider both of these factors.

PLASMA PROLACTIN AND PROGESTERONE RESPONSES TO MATING ARE ALTERED IN AGED RATS

1981 ◽  
Vol 90 (2) ◽  
pp. 179-191 ◽  
Author(s):  
S. HENDRICKS ◽  
C. A. BLAKE
Keyword(s):  
Plasma Concentrations ◽  
External Jugular Vein ◽  
Female Rats ◽  
Plasma Prolactin ◽  
Aged Rats ◽  
Pregnant Rats ◽  
Pregnant Rat ◽  
Plasma Progesterone ◽  
The One ◽  
The Right

The effects of varying amounts of copulatory stimulation on patterns of plasma concentrations of prolactin and progesterone were evaluated in 3- and 12-month-old female rats. The 12-month-old group included rats which still exhibited oestrous cycles and rats in persistent vaginal oestrus (PVO). The extent of copulatory stimulation was defined by the number of intromissions received during mating: ≤5,15 or > 50. Blood samples were drawn over the 8 days after mating through a cannula inserted into the right external jugular vein. Plasma from the samples was assayed for prolactin and progesterone. In aged but still cyclic rats, pregnancy rates were positively correlated with the number of intromissions received during mating. Only one rat in PVO became pregnant. All animals which became pregnant and rats in PVO which, after mating, exhibited a disruption of the pattern of PVO, showed the nocturnal surge of plasma prolactin characteristic of pregnant and pseudopregnant rats. While these surges persisted until day 8 after mating in pregnant animals, they were absent by this time in the rats in PVO. Prolactin surges were present in some but not all of the aged rats which did not become pregnant. Progesterone concentrations were raised in all pregnant animals except the one pregnant rat in PVO and, while not related to the number of intromissions, concentrations were higher 8 days after mating in young compared with those in aged pregnant rats. Plasma progesterone was low in rats in PVO regardless of disruption of the pattern of PVO. We have concluded that the failure of limited copulatory stimulation to induce pregnancy in older rats results, at least in part, from its failure to initiate nocturnal prolactin surges. Nevertheless, our data suggest that matings which are not experimentally limited should provide ample stimulation to establish such surges. Although reduced plasma concentrations of prolactin and progesterone at pro-oestrus and reduced plasma progesterone through part of gestation may contribute to decreasing fertility in aged rats, other unidentified factors appear to be involved in mediating the capacity of extensive copulatory stimulation to induce pregnancy in these animals.

Abstract 89: The Ventriculo-Ventricular Coupling Index: A Novel Approach to Assessing Biventricular Function

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Navin K Kapur ◽  
Mark J Aronovitz ◽  
Robert Blanton ◽  
Emily Mackey ◽  
Vikram Paruchuri ◽  
...  
Keyword(s):  
Heart Failure ◽  
Steady State ◽  
Left Ventricular ◽  
External Jugular Vein ◽  
Arterial Elastance ◽  
Left Heart Failure ◽  
Novel Approach ◽  
Coupling Index ◽  
Ventricular Efficiency ◽  
The Right

Bi-ventricular (Bi-V) function in primary pulmonary hypertension (PPH) or PH secondary to left heart failure (SPH) remains difficult to characterize. As a measure of ventricular efficiency, ventriculo-arterial coupling (VAC) is calculated as the ratio of effective arterial elastance (Ea) to end-systolic elastance (Ees). No measure currently assesses ventriculo-ventricular coupling (VVC). Therefore, we developed a novel catheter-based approach to quantify Bi-V function using pressure-volume loop (PVL) analysis and hypothesized that Bi-V VAC ratios, defined as the VVC index (VVCI), may discriminate PPH and SPH. Methods: Adult male mice (n=6/group) underwent constriction of the pulmonary artery (PAC) or thoracic aorta (TAC) to model PPH and SPH respectively. Sham-operated animals underwent a left thoracotomy. Closed chest simultaneous Bi-V catheterization was performed after 7 days in PPH and 10 weeks in SPH. Conductance catheters were used for right and left ventricular PVL analysis via the right external jugular vein and right common carotid artery under steady-state conditions and with variable preload. Results: Steady-state Bi-V PVL and changes in VAC ratios and the VVCI are shown below. In sham mice VAC ratios and the VVCI reflect optimal ventricular efficiency. In PPH, the VVCI is significantly increased, while in SPH, the VVCI is significantly decreased compared to controls. Conclusion: These results identify a novel method to quantify Bi-V function in mice and further show that the VVCI can distinguish PPH and SPH. These findings have important implications for examining cardiac function in preclinical and clinical studies of left- and right-sided heart failure.

Turns on the Move

2019 ◽  
pp. 73-76
Author(s):  
K. B. E. E. Eimeleus
Keyword(s):  
The Other ◽  
Left Shoulder ◽  
Sudden Stop ◽  
Flat Terrain ◽  
Right Hand ◽  
The World ◽  
The Right

This chapter looks at turns on the move with the right or left shoulder aligned with the corresponding ski. It distinguishes three important techniques that have gained currency in the world of sport. One of them pertains only to running skis while the other two require mountain skis with stable bindings. The first is the method for turning in place, used while descending from a mountain or over flat terrain on running skis, or on any skis that lack a stable binding and have a posterior center of balance. The next is the Christiania turn, which is carried out on the inner ski, that is, on the right ski when the turn is done to the right-hand side. Finally, the Telemark turn allows a skier to make a sudden stop as they are descending.

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