Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242429 (sore throat)
 2,760 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 52-year-old man, without previous disease, presented with dysphagia, dyspnoea, high fever and sore throat after peritonsillar abscesses drainage. Physical and complementary examinations were consistent with pericarditis, mediastinitis, pneumonia and pleuritis. Blood cultures grew Eikenella corrodens resistant to clindamycin and amikacin. We emphasize the pathogenic potential of Eikenella corrodens. To the best of our knowledge, this is the first reported case of this organism as a pathogen in intrathoracic infections after peritonsillar abscesses drainage.
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PMID:Intrathoracic infections with bacteraemia due to Eikenella corrodens as a complication of peritonsillar abscesses: report of a case and review of the literature. 132 37

Life threatening mediastinitis as a complication of acute epiglottitis is very rare. A 38-year-old male in previously good health was admitted to our hospital in a state of unconsciousness. Seven days prior to admission he had complained of a sore throat, dysphagia, high fever and dyspnea. A chest X-ray on admission showed widening of the mediastinum, mediastinal emphysema, subcutaneous emphysema and left pleural effusion. Bronchoscopy showed the swelling of supraglottic structures. He was diagnosed as having acute mediastinitis and pyothorax as a complication of acute epiglottitis, but pathogens were not identified. The blood was hyperglycemic and insulin therapy was started. Though he gradually improved by massive antibiotic therapy, steroid therapy, tracheotomy and surgical drainage of both the left thoracic cavity and the mediastinum, he died suddenly of massive hemoptysis. Autopsy revealed that the acute mediastinitis had healed, but that the Aspergillus infection was present in both lungs and the pericardium. The Aspergillus infection was not lethal in the present case, and it seemed that death had resulted from arterial hemorrhage caused by erosion of the trachea. The present case suggests the need for antifungal therapy even in non-immunocompromised patients in particular when massive doses of antibiotics and steroids are administered.
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PMID:[A case of mediastinitis and bilateral pyothorax, following acute epiglottitis with concurrent Aspergillus infection]. 140

A 71-year-old woman was transferred to Kushiro City General Hospital because of fever, sore throat, diffuse neck swelling and dyspnea. She had received right mastectomy for breast cancer under general anesthesia 6 days before the admission. The lateral X-ray film of the neck revealed abscess in the retropharyngeal space and the retroesophageal space. CT scan revealed mediastinitis. Next day she received neck dissection for drainage of the abscess under general anesthesia. Although the posterior pharyngeal wall was swollen, endo-tracheal intubation was not difficult. Brown tinged and purplish pus was aspirated from the interspace of carotid sheath and trachea, the retropharyngeal space, and the superior mediastinal space. The infected site was irrigated with a lot of peroxide and saline and draining tubes were placed in each interspace. Tracheostomy was not done but the patient was admitted to the ICU with her trachea intubated. The day after operation, she was extubated. Three days after the operation chest X-ray revealed pyothorax and chest tube was inserted for drainage. Seven days after the operation she was transferred to the ENT ward. Thereafter her recovery course was uneventful. It seems that the deep neck infection was probably caused by the injury on endotracheal intubation at the first operation in this case. Although this patient was cured of mediastinitis following deep neck infection, which is still lethal, early diagnosis and surgical drainage of the abscess are necessary.
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PMID:[Deep neck infection following endotracheal intubation]. 147 68

The clinical features and management of eight patients with parapharyngeal space infection who presented with swelling of the neck subsequent to sore throat are described. In four patients the interval between the initial throat symptoms and swelling was 2 days or less, and the disease was rapidly progressive with stridor or a descending mediastinitis. In the other four cases, this interval was longer (4 to 14 days) and the infection was fairly localized. Computed tomography was useful for making the diagnosis, establishing that the infection had spread into other deep neck spaces and the mediastinum, distinguishing abscesses from diffuse cellulitis, guiding drainage aspiration, and assessing the response to therapy. None of the patients underwent extensive surgical drainage of the deep neck spaces. A nonsurgical approach with antibiotics, including high doses of benzylpenicillin, and computed tomography-guided selective needle aspirations proved successful. Even patients with distinct abscesses were completely cured.
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PMID:Clinical infections and nonsurgical treatment of parapharyngeal space infections complicating throat infection. 260 77

Mediastinitis is a life-threatening complication of cardiac, neck and oesophageal surgery. It has also been reported following upper digestive and respiratory procedures and as a consequence of oesophageal perforation following the ingestion of foreign bodies. Much more infrequently, mediastinitis can occur in association with oropharyngeal or cervical infections. We describe the case of a patient with fatal mediastinitis and septic shock. The onset of mediastinitis was preceded by a 2-day course of sore throat and other flu-like symptoms.
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PMID:Fatal Streptococcus viridans descending mediastinitis: case report and review of the literature. 922 54

A 69-year-old man complained of a sore throat, neck swelling, and disturbance of swallowing with dyspnea. He underwent tracheostomy and cervical drainage. The plain chest roentgenogram and CT scans suggested mediastinitis, so he was transferred to our hospital. Cultures revealed a mixed aerobic and anaerobic infection. On hospital day 2, the neck was explored and pus was found in the connective tissue. Despite drainage and intravenous panipenem with betamipron and clindamycin, he remained febrile and a mediastinal abscess was seen on repeat CT. On hospital day 10, reexploration of the mediastinum was done through cervical and right thoracotomy incisions. A large amount of pus was drained from the posterior mediastinum and its necrotic tissue was debrided. Myocardial infarction occurred intraoperatively, but the patient was successfully resuscitated. Following this procedure, the patient's condition and radiologic findings gradually improved. Cultures of the drain fluid became negative, and he was discharged on hospital day 103. In conclusion, both transcervical drainage and aggressive mediastinal exploration via thoracotomy are essential to salvage a patient with descending necrotizing mediastinitis. CT scanning is useful for early diagnosis of mediastinitis and for follow up.
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PMID:[Descending necrotizing mediastinitis secondary to retropharyngeal abscess--a case report]. 930 Dec 36

We report a case of spontaneous parathyroid adenoma hemorrhage. A 50-year-old man with a sore throat, and swelling and ecchymosis of the entire anterior neck was found in cervical and chest computed tomography revealed to have a low-density area extending from the parapharyngeal region to below the carina, Suspecting descending necrotizing mediastinitis secondary to a peritonsillar abscess, we conducted mediastinal and cervical drainage, but found no abscess. No evidence was found, either, in bacteriological culture of sputum and pleural effusion. After the hematoma disappeared, cervical ultrasonography indicated parathyroid adenoma. Serum calcium was marginally increased, indicating that serum calcium should be determined if cervical or mediastinal hematoma develops without an obvious cause.
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PMID:Spontaneous parathyroid adenoma hemorrhage. 1238 9

Descending necrotising mediastinitis is an uncommon disease in the emergency department. Early recognition is important for a good prognosis for this fatal condition. This report describes a case of a healthy 79 year old woman who was seen in the urgent care centre with the initial presentation of chest pain. Misdiagnosis was made because of the mis-reading of a flap-like artefact over the ascending aorta and difficulty interpreting subtle change of mediastinal soft tissue infiltration. The patient was then treated as dissecting aneurysm over ascending aorta until her condition deteriorated. Although aggressive treatment comprising thoracotomy, cervical incision and drainage, and antibiotics were begun, the response was poor. Emergency physicians should be familiar with this rare but highly lethal disease. Correlation should be made in a patient complaining about chest pain, especially combined with fever, sore throat, dysphagia, or neck swelling.
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PMID:Descending necrotising mediastinitis: a report of misdiagnosis as thoracic aortic dissection. 1573 82

Lemierre syndrome is characterized by an acute oropharyngeal infection, suppurative thrombophlebitis of the internal jugular vein and metastatic infections. The infection is usually caused by Fusobacterium necrophorum. We report on a 19-year-old male patient who was admitted with a five-day history of fever, sore throat and progressive dyspnea. Computed tomography of the neck and chest revealed a parapharyngeal abscess, jugular vein thrombosis, descending necrotizing mediastinitis and multiple areas of bilateral consolidation and cavitations within the lungs. Fusobacterium necrophorum was identified in the blood culture. Early combined abscess drainage with neck and chest incisions, together with broad spectrum intravenous antibiotic treatment and medical management in an intensive care unit resulted in a good clinical outcome.
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PMID:From a sore throat to the intensive care unit: the Lemierre syndrome. 1679 63

Descending necrotizing mediastinitis (DNM) is a rare but severe disease with a high mortality rate. We report a case of a 77-year-old woman with DNM who was treated using video-thoracoscopic drainage and a Blake drain. She was admitted to our hospital with a 3-day history of a sore throat. Computed tomography (CT) revealed a peritonsillar abscess descending into the anterior and posterior mediastinum below the carina. She was diagnosed with DNM, and emergency surgery was performed. The mediastinal abscess was drained via video-thoracoscopy, and a 24F Blake drain was inserted into the mediastinum. Following mediastinal drainage, cervical drainage was performed for treatment of the retropharyngeal abscess. The outcome of videothoracoscopic mediastinal drainage was satisfactory, and no further invasive treatment was required. We believe that video-thoracoscopic mediastinal drainage is an effective, minimally invasive treatment for DNM with subcarinal spread. Blake drains are useful for mediastinal drainage.
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PMID:Successful video-thoracoscopic drainage for descending necrotizing mediastinitis. 1921 54


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