Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031350 (pharyngitis)
 2,405 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have recently encountered two instances of septicemia due to Fusobacterium necrophorum in adolescents. The presence of severe exudative pharyngitis in both patients pointed to the upper respiratory tract as the probable portal of entry. In one case, metastatic infection was manifested by multiple septic pulmonary emboli with associated pleural effusions. In the other case, diffuse encephalopathy and septic arthritis of the left shoulder and hip occurred. Unilateral neck pain, persistent bacteremia, and prolonged fever despite appropriate antibiotics were consistent with the presence of septic jugular thrombophlebitis in both patients. "Postanginal septicemia" caused by F necrophorum, described by Lemierre in the preantibiotic era, was undoubtedly the syndrome manifested by these patients. This condition, formerly uniformly fatal, can readily be diagnosed when anaerobic techniques are used for blood culture, but requires prolonged antibiotic therapy for cure.
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PMID:Metastatic complications of Fusobacterium necrophorum sepsis. Two cases of Lemierre's postanginal septicemia. 736 98

A 14-year-old previously healthy female was transferred from a local emergency department after being found unresponsive at home. Parental questioning revealed she had fever and pharyngitis 2 weeks before presentation. Past mental health history was negative, including concern for past or present suicidal ideation/attempts, suspected substance use, or toxic ingestion. In the emergency department, she was orotracheally intubated due to a Glasgow Coma Scale of 3. She was hemodynamically stable and euglycemic. Electrocardiogram showed sinus tachycardia. She underwent a noncontrast head computed tomography that was normal and subsequently underwent a lumbar puncture. She had a seizure and was given a loading dose of diazepam and fosphenytoin that led to cessation of extremity movements. She was subsequently transferred to the PICU for additional evaluation. Initial examination without sedation or analgesia demonstrated dilated and minimally responsive pupils, intermittent decorticate posturing, and bilateral lower extremity rigidity and clonus, consistent with a Glasgow Coma Scale of 5. Serum studies were unremarkable with the exception of mild leukocytosis. Chest radiograph only showed atelectasis. She was empirically started on antibiotics to cover for meningitis pending final cerebral spinal fluid test results. The pediatric neurology team was consulted for EEG monitoring, and the patient was eventually sent for computed tomography angiogram and magnetic resonance angiogram/venogram. We will review diagnostic evaluation and management of an adolescent patient with acute encephalopathy with decorticate posturing of unclear etiology.
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PMID:A Previously Healthy Adolescent With Acute Encephalopathy and Decorticate Posturing. 2794 May 5