[Lemierre's syndrome from necrotizing pneumonia treated with extracorporeal CO2 removal].

Département d'anesthésie et de réanimation, CHU de Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
Annales francaises d'anesthesie et de reanimation (Impact Factor: 0.84). 04/2008; 27(3):244-8.
Source: PubMed


We report a case of Lemierre's syndrome complicated with pulmonary septic abscesses, leading to necrotizing pneumonia. In spite of administration of appropriate antibiotics and a protective ventilation strategy, the patient had several bilateral pneumothoraces. In this setting, the mechanical ventilation was unsuccessful leading to two hypoxia-related cardiac arrests. An extracorporeal CO(2) removal was then carried out for 34-days duration. The patient was weaned from mechanical ventilation on day 68. He was then transferred to the chest surgery unit on day 83.

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    ABSTRACT: Lemierre's syndrome is a classical presentation of human necrobacillosis. It is characterized by a primary infection in the face including a septic thrombophlebitis of the internal jugular vein and disseminated metastatic abcesses. Fusobacterium necrophorum is the main pathogen found in that syndrome. The diagnosis is based on clinical features, then on the microbiology with positive anaerobic blood cultures as key role and finally on the computed tomography. Most of the time a well-chosen antibiotic treatment against anaerobic pathogens and Gram negative bacilli is efficient but surgery can be useful. We report a case of a 73 years old man, which seems to be unique because it is the first case reported of a Lemierre's syndrome characterized by a parotitis infected by F. necrophorum.
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