Tuesday, September 16, 2014
Sunday, January 12, 2014
Thrombophlebitis of the internal jugular vein is becoming less rare in the 21st century
Published in the International Journal of Emergency Medicine; the following abstract which points out the condition is characterized by thrombophlebitis. My daughter Bri still follows a regimen of anticoagulation with warfarin (blood thinner).
"Lemierre’s syndrome is a condition characterized by thrombophlebitis of the internal jugular vein and bacteremia caused by primarily anaerobic organisms, following a recent oropharyngeal infection. This has been an uncommon illness in the era of antibiotic therapy, though it has been reported with increasing frequency in the past 15 years. Lemierre’s syndrome should be suspected in young healthy patients with prolonged symptoms of pharyngitis followed by symptoms of septicemia or pneumonia, or an atypical lateral neck pain. Diagnosis is often confirmed by identification of thrombophlebitis of the internal jugular vein and growth of anaerobic bacteria on blood culture. Treatment involves prolonged antibiotic therapy occasionally combined with anticoagulation."
Common findings in this particular report:
1. Fever is the most common physical finding, present in 92% of 100% of cases.
2. Followed by Pharyngitis or peritonsillar abscess and neck mass. A mass in the neck may be palpable at the angle of the jaw.
3. Frequently, a mass in this location is mistaken for enlarged lymph nodes.
My daughter had excruciating neck pain, but we and her doctors in the ER mistook it for throat pain.
"Lemierre’s syndrome is a condition characterized by thrombophlebitis of the internal jugular vein and bacteremia caused by primarily anaerobic organisms, following a recent oropharyngeal infection. This has been an uncommon illness in the era of antibiotic therapy, though it has been reported with increasing frequency in the past 15 years. Lemierre’s syndrome should be suspected in young healthy patients with prolonged symptoms of pharyngitis followed by symptoms of septicemia or pneumonia, or an atypical lateral neck pain. Diagnosis is often confirmed by identification of thrombophlebitis of the internal jugular vein and growth of anaerobic bacteria on blood culture. Treatment involves prolonged antibiotic therapy occasionally combined with anticoagulation."
Common findings in this particular report:
1. Fever is the most common physical finding, present in 92% of 100% of cases.
2. Followed by Pharyngitis or peritonsillar abscess and neck mass. A mass in the neck may be palpable at the angle of the jaw.
3. Frequently, a mass in this location is mistaken for enlarged lymph nodes.
My daughter had excruciating neck pain, but we and her doctors in the ER mistook it for throat pain.
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