Differential diagnosis and effective therapy for sore throat

Sore throat is a common complaint, which can be caused by a typical viral pharyngitis, or it can be rooted in a life-threatening disease such as epiglottitis or inflammation of the cellular spaces in the throat and neck. The doctor should take a closer look at a patient with a sore throat, immediately make a differential diagnosis and prescribe adequate treatment, including surgical intervention, if necessary.The article discusses the most common causes of a sore throat, including various types of pharyngitis, paratonsillar abscess, parapharyngeal abscess, retropharyngeal abscess, epiglottitis.Viral pharyngitis has a favourable prognosis, resolves without intervention and complications, but bacterial and fungal pharyngitis have a more severe course. Streptococcal pharyngitis caused by group A в-hemolytic streptococcus holds a dominant position in bacterial etiology and requires the use of antibiotic therapy. The differential diagnosis of streptococcal pharyngitis is based on the modified Centor scores in the routine clinical practice. Antibiotic therapy for streptococcal pharyngitis includes a 10-day course of unprotected penicillins. If a patient has an allergic reaction to penicillins, it is recommended to use clindamycin or clarithromycin. The surgical intervention combined with intramuscular or intravenous antibiotic therapy is recommended for the treatment of purulent processes in the cellular spaces of the neck. These diseases can have life-threatening complications, which include neurological damage, the spread of purulent process in the mediastinum with the development of mediastinitis, laryn-geal stenosis, sepsis, necrotizing fasciitis, jugular vein thrombosis and erosion of the carotid artery. The third generation cephalosporins and protected penicillins are recommended for the treatment of epiglottitis, and respiratory fluoroquinolones are used, if a patient has a history of allergic reactions to penicillins. In severe cases with symptoms of stenosis, intubation can be performed in addition to the use of antibiotics.

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A dangerous cause of airway obstruction: deep neck infection

10.22514/sv.2020.16.0101 ◽

2020 ◽

Keyword(s):

Airway Obstruction ◽

Upper Airway ◽

Deep Neck Infection ◽

Jugular Vein Thrombosis ◽

Neck Infection ◽

Vein Thrombosis ◽

Lethal Complications ◽

Life Threatening ◽

Fascial Spaces ◽

Emergency Doctors

Deep neck infection (DNI) is an infection in the fascial spaces of the neck. Complications of DNI, including mediastinitis, internal jugular vein thrombosis, and upper airway obstruction, are severe and potentially life threatening. Therefore, early identification and accurate management of DNI are essential. We review the anatomy of the deep spaces of the neck to determine the route of DNI spread so that emergency doctors, physicians, and otorhinolaryngologists can quickly recognize the development of lethal complications of DNI, such as asphyxia from airway obstruction.

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Hemoperitoneum in a Peritoneal Dialysis Patient: Ruptured Ectopic Pregnancy

Peritoneal Dialysis International ◽

10.3747/pdi.2018.00066 ◽

2018 ◽

Vol 38 (6) ◽

pp. 455-456 ◽

Cited By ~ 1

Author(s):

Orly F. Kohn ◽

Sandra Culbertson ◽

Yolanda T. Becker

Keyword(s):

Differential Diagnosis ◽

Peritoneal Dialysis ◽

Ectopic Pregnancy ◽

Dialysis Patient ◽

Surgical Intervention ◽

Peritoneal Dialysis Patient ◽

Dialysis Patients ◽

Childbearing Age ◽

Life Threatening ◽

High Index Of Suspicion

Hemoperitoneum is a well-recognized complication in female peritoneal dialysis (PD) patients of childbearing age. Bloody effluent is commonly of minor nature, presenting during menstruation or midcycle, resolving after a few rapid exchanges without a need for further intervention. One must remain vigilant, however, and consider a broader differential diagnosis when hemoperitoneum is persistent or severe, as it indicates a serious and potentially life-threatening etiology. We report 2 episodes of hemoperitoneum in a PD patient occurring more than 1.5 years apart, with different underlying etiologies. The more dramatic second episode was due to a ruptured ectopic pregnancy, a condition which had not been reported as a cause of hemoperitoneum in dialysis patients to date and requires a high index of suspicion and prompt surgical intervention.

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Lemierre’s syndrome: a complication of acute oropharyngitis

The Journal of Laryngology & Otology ◽

10.1258/0022215001906110 ◽

2000 ◽

Vol 114 (7) ◽

pp. 545-547 ◽

Cited By ~ 27

Author(s):

R. Agarwal ◽

P. S. Arunachalam ◽

D. A. Bosman

Keyword(s):

Case Report ◽

Sore Throat ◽

Cranial Nerve ◽

Jugular Vein ◽

Lemierre’S Syndrome ◽

Jugular Vein Thrombosis ◽

Vein Thrombosis ◽

Cranial Nerve Palsies ◽

Internal Jugular Vein Thrombosis ◽

Lemierre's Syndrome

Lemierre’s syndrome is a recognized but infrequently seen complication of acute oropharyngitis. In this case report the patient presented with acute sore throat that led to a bacteraemia with internal jugular vein thrombosis and subsequent cranial nerve palsies.

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Odontogenic phlegmon of the mouth floor: a case report

Progress in Health Sciences ◽

10.5604/01.3001.0009.5166 ◽

2016 ◽

Vol 6 (2) ◽

pp. 0-0

Author(s):

P. Bortnik ◽

P. Wieczorek ◽

P. Załęski ◽

P. Kosierkiewicz ◽

A. Siemiątkowski ◽

...

Keyword(s):

Case Report ◽

Antibiotic Therapy ◽

Plastic Surgery ◽

Successful Treatment ◽

Surgical Intervention ◽

University Hospital ◽

Local Complication ◽

Life Threatening ◽

Ludwig’S Angina ◽

The University

Odontogenic phlegmon of the mouth floor—Ludwig's angina (phlegmonae fundi cavi oris seu angina Ludovici)—is a rare, life-threatening, local complication in most cases of odontogenic inflammation. This study presents the case of a patient treated in the Department of Maxillofacial and Plastic Surgery of the University Hospital in Białystok due to phlegmon of the mouth floor resulting from odontogenic inflammation with a dynamic course. Quick diagnostics, surgical intervention as well as antibiotic therapy contributed to its efficient and successful treatment.

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Not just a simple sore throat

Acute Medicine Journal ◽

10.52964/amja.0673 ◽

2017 ◽

Vol 16 (3) ◽

pp. 145-148

Author(s):

Olivia Jones ◽

◽

Aram Salehi ◽

Keyword(s):

Sore Throat ◽

Inflammatory Markers ◽

Jugular Vein ◽

Symptomatic Treatment ◽

Fusobacterium Necrophorum ◽

Jugular Vein Thrombosis ◽

Vein Thrombosis ◽

Persistent Symptoms ◽

Internal Jugular Vein Thrombosis ◽

Arcanobacterium Haemolyticum

The presentation of a ‘sore throat’ is common and often requires only symptomatic treatment. This is the case of a 20-year-old female who presented with persistent symptoms of a sore throat. On admission she had raised inflammatory markers and a subsequent blood culture demonstrated a fusobacterium necrophorum and arcanobacterium haemolyticum bacteraemia. Further investigations established an internal jugular vein thrombosis, confirming the diagnosis of Lemierre’s syndrome. This case highlights the importance of further investigation when a sore throat fails to improve, and to remember this often-forgotten syndrome.

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Extended-spectrum β-lactamase-producing Escherichia coli rib osteomyelitis with debridement and vacuum-assisted closure

BMJ Case Reports ◽

10.1136/bcr-2020-238029 ◽

2021 ◽

Vol 14 (1) ◽

pp. e238029

Author(s):

Suguru Mitsui ◽

Shunsuke Tauchi ◽

Shinpei Mizuki ◽

Satoshi Tobe

Keyword(s):

Escherichia Coli ◽

Differential Diagnosis ◽

Chest Pain ◽

Surgical Treatment ◽

Antibiotic Therapy ◽

Surgical Intervention ◽

Drug Resistant ◽

Vacuum Assisted Closure ◽

Extended Spectrum ◽

Prolonged Antibiotic Therapy

Rib osteomyelitis is a rare disease, comprising 1% or less of all osteomyelitis. Treatment of rib osteomyelitis includes prolonged antibiotic therapy and surgical intervention. Indications for surgical treatment of rib osteomyelitis remain unclear, however, because of few reported cases. We report the first known case of extended-spectrum β-lactamase-producing Escherichia coli rib osteomyelitis caused by urosepsis. The 69-year-old male patient remains free of recurrence and symptoms after rib resection and vacuum-assisted closure treatment with antibiotic therapy. Rib osteomyelitis should be considered as differential diagnosis when patients report chest pain after bacteraemic infection. We recommend surgical treatment for patients with drug-resistant bacterial rib osteomyelitis.

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Fascial Space Infections

Oral and Maxillofacial Surgery for the Clinician ◽

10.1007/978-981-15-1346-6_21 ◽

2021 ◽

pp. 441-459

Author(s):

Rajasekhar Gaddipati

Keyword(s):

Signs And Symptoms ◽

Definitive Treatment ◽

Jugular Vein Thrombosis ◽

Ancient Civilization ◽

Vein Thrombosis ◽

Microbial Infections ◽

Life Threatening ◽

The Common ◽

Fascial Space ◽

Different Levels

AbstractDental infection has plagued humankind for as long as our civilization has been a fight against microorganisms by man dates back to ancient civilization. The discovery of antibiotics is encouraging trends conquest of the microbial infections. Infection of the deep facial spaces of the head and neck still represents a major challenge in hospitals. Untreated infections may result in abscess formation that can spread through different levels in and between the facial spaces and result in life-threatening situations including mediastinitis, pericarditis, meningitis, septic shock, airway compromise, jugular vein thrombosis, and arterial erosion, Although the complications are rare, they are serious and life threatening. The most critical point in the facial space infections is the understanding of the common and uncommon signs and symptoms, choice of antibiotics, definitive treatment and a thorough knowledge about the sequela if left unmanaged.

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Febrile torticollis in an infant: what is your diagnosis?

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20211954 ◽

2021 ◽

Vol 7 (6) ◽

pp. 316

Author(s):

Ilham Rkain ◽

Safaa Toutimi

Keyword(s):

Antibiotic Therapy ◽

Ct Scan ◽

Retropharyngeal Abscess ◽

Retropharyngeal Space ◽

Upper Respiratory Tract ◽

Early Management ◽

Space Management ◽

Computed Tomographic ◽

Contrast Agent Injection ◽

Life Threatening

Retropharyngeal abscess is a rare but serious infection, in children, it is often secondary to upper respiratory tract infections.We report the case of an 18-month-old infant admitted to the emergencies for acute febrile torticolis. A computed tomographic (CT) scan with contrast agent injection revealed a collection of the retropharyngeal space; management consisted of triple antibiotic therapy and transoral drainage. The evolution was made towards a clinical and biological improvement. Retropharyngeal abscess should be suspected in front of dysphagia, cervical stiffness associated with a febrile syndrome, CT scan confirms the diagnosis and early management by intravenous antibiotic therapy whether or not combining surgical drainage, which remains a subject of discussion. Early diagnosis and management help to avoid life-threatening complications.

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Acute descending necrotizing mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes

Journal of Health Sciences ◽

10.17532/jhsci.2020.1041 ◽

2020 ◽

Author(s):

Ilijaz Pilav ◽

Orhan Čustović ◽

Arijana Horman-Leventa ◽

Alma Alihodžić-Pašalić ◽

Safet Mušanović ◽

...

Keyword(s):

Surgical Intervention ◽

Severe Form ◽

Primary Site ◽

Retropharyngeal Abscess ◽

Retropharyngeal Space ◽

Descending Necrotizing Mediastinitis ◽

Prompt Treatment ◽

Empirical Antibiotic Treatment ◽

Clinical Center ◽

Life Threatening

Descending necrotizing mediastinitis (DNM) is a rare, life-threatening form of mediastinitis caused by odontogenic, pharyngeal, or cervical infections. The retropharyngeal space is the most common primary site of infection. Given the fulminant course and high mortality rate, early diagnosis and prompt treatment are important predictors of survival in patients with DNM. Appropriate empirical antibiotic treatment, prompt surgical intervention, and proper management of patients in the intensive care unit can be of vital importance. We present the case of a previously healthy 20-year-old male patient who was successfully cured and discharged from the Clinical Center University of Sarajevo after suffering from a severe form of mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes.

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Lemierre's Syndrome: A Case of a Large Inflammatory Neck Mass with Internal Jugular Vein Thrombosis and Literature Review of Its Surgical Intervention

10.21203/rs.3.rs-543943/v1 ◽

2021 ◽

Author(s):

Yilin Shen ◽

Bin Ye ◽

Qian Da ◽

Chaofu Wang ◽

Mingliang Xiang

Keyword(s):

Surgical Treatment ◽

Internal Jugular Vein ◽

Surgical Intervention ◽

Jugular Vein ◽

Neck Mass ◽

Lemierre’S Syndrome ◽

Jugular Vein Thrombosis ◽

Vein Thrombosis ◽

Internal Jugular Vein Thrombosis ◽

Lemierre's Syndrome

Abstract Background: Lemierre's syndrome is a fatal and rare disease that is typically characterized by oropharyngeal infection and internal jugular vein thrombosis. Timely application of appropriate antibiotics is the standard treatment. However, when conservative medical treatment fails to have effect, surgical intervention may be the only effective option for controlling the source of infection. Case presentation: The authors report a case of Lemierre's syndrome with a large inflammatory neck mass involving left internal jugular vein thrombosis that was cured by surgical treatment. In addition, a literature review was carried out through PubMed using the terms “Lemierre’s syndrome/disease and review, meta-analysis or retrospective study” and “Lemierre’s syndrome/disease and internal jugular vein”. This search yielded 6 articles that recorded the surgical rate in detail. Conclusion: The purpose of this review was to summarize the conditions under which surgical treatment are conducted. Additionally, this is the first report of such a large inflammatory neck mass that was completely cured by surgical resection and internal jugular vein ligation. The authors further offer several conclusions regarding surgical intervention in Lemierre’s syndrome.

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