title: Just a sore throat? Uncommon causes of significant respiratory disease.
abstract: We present two uncommon underlying causes of a sore throat which, if missed or delayed in diagnosis, can lead to disastrous consequences. Our first case is of Lemierre's syndrome diagnosed in a 21-year-old man presenting with a 5-day history of sore throat, fever, right-sided pleuritic chest pain and bilateral pulmonary nodules on CT imaging. Fusobacterium necrophorum cultured from peripheral blood and an occluded left internal jugular vein on ultrasound lead to an eventual diagnosis. Our second case presents a 29-year-old woman with a 5-day history of sore throat, fever and right-sided pleuritic chest pain. A left-sided quinsy was diagnosed and aspirated and the patient was discharged home. She represented shortly with worsening pleuritic pain and was found to have a right-sided pleural effusion with descending mediastinitis originating from the tonsillar abscess. Delayed diagnosis resulted in open thoracotomy, decortication and prolonged intravenous antibiotics.
authors: Department of Respiratory, Royal Brompton Hospital, London, UK. D.Wahab@rbht.nhs.uk
authors: Dalia
authors: D
authors: Wahab
authors: Julia
authors: J
authors: Bichard
authors: Anand
authors: A
authors: Shah
authors: Bhupinder
authors: B
authors: Mann
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004322:Drainage; D005260:Female; D006801:Humans; D057831:Lemierre Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D000039:Peritonsillar Abscess / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D010612:Pharyngitis / Q000209:etiology*; D010996:Pleural Effusion / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D020775:Thoracic Surgery, Video-Assisted
chemical_list: D000890:Anti-Infective Agents
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