Descending necrotizing mediastinitis with Lemierre's syndrome.
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.
Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Taisuke
T
Kaiho
Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan. takahiro_nakajima@med.miyazaki-u.ac.jp.
Takahiro
T
Nakajima
Department of Otorhinolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Shuji
S
Yonekura
Department of Otorhinolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Sawako
S
Hamasaki
Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Takekazu
T
Iwata
Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Ichiro
I
Yoshino
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D057831:Lemierre Syndrome / Q000150:complications* / Q000175:diagnosis; D008480:Mediastinitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D008875:Middle Aged; D009336:Necrosis; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D034365:Streptococcus constellatus / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents
Descending necrotizing mediastinitis; Lemierre’s syndrome; Septic pulmonary embolization