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General Thoracic and Cardiovascular Surgery
Published in: General Thoracic and Cardiovascular Surgery 11/2017

01-11-2017 | Case Report

Descending necrotizing mediastinitis with Lemierre’s syndrome

Authors: Taisuke Kaiho, Takahiro Nakajima, Shuji Yonekura, Sawako Hamasaki, Takekazu Iwata, Ichiro Yoshino

Published in: General Thoracic and Cardiovascular Surgery | Issue 11/2017

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Abstract

Descending necrotizing mediastinitis is a severe infection of the mediastinum. Lemierre’s syndrome manifests as thrombophlebitis in the cervical veins, which is caused by a neck infection. A 50-year-old woman had a fever with a 13-day history of neck pain. CT showed a deep neck abscess with vertebral vein thrombosis and mediastinal abscesses. Multiple small pulmonary nodules were found, suggesting septic pulmonary embolism. Emergency surgery for bilateral cervical and mediastinal drainage was performed, and antibiotics and anticoagulation agent was administered. Edoxaban was required to clear vein thrombosis and pulmonary embolization.
Literature
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Endo S, Murayama F, Hasegawa T, Yamamoto S, Yamaguchi T, Sohara Y, et al. Guideline of surgical management based on diffusion of descending necrotizing mediastinitis. Jpn J Thorac Cardiovasc Surg. 1999;47:14–9.CrossRefPubMed
2.
Freeman RK, Vallières E, Verrier ED, Karmy-Jones R, Wood DE. Descending necrotizing mediastinitis: an analysis of the effects of serial surgical debridement on patient mortality. J Thorac Cardiovasc Surg. 2000;119:260–7.CrossRefPubMed
3.
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;36:1044–51.CrossRefPubMed
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Karkos PD, Asrani S, Karkos CD, Leong SC, Theochari EG, Alexopoulou TD, et al. Lemierre’s syndrome: A systematic review. Laryngoscope. 2009;119:1552–9.CrossRefPubMed
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Cook RJ, Ashton RW, Aughenbaugh GL, Ryu JH. Septic pulmonary embolism: presenting features and clinical course of 14 patients. Chest. 2005;128:162–6.CrossRefPubMed
Metadata
Title
Descending necrotizing mediastinitis with Lemierre’s syndrome
Authors
Taisuke Kaiho
Takahiro Nakajima
Shuji Yonekura
Sawako Hamasaki
Takekazu Iwata
Ichiro Yoshino
Publication date
01-11-2017
Publisher
Springer Japan
Published in
General Thoracic and Cardiovascular Surgery / Issue 11/2017
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-016-0742-0

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