amoxicillin-potassium-clavulanate-combination and Embolism

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cervical Vertebrae; Clindamycin; Drug Therapy, Combination; Embolism; Female; Gram-Positive Bacterial Infections; Headache; Humans; Lemierre Syndrome; Myalgia; Peptostreptococcus; Retropharyngeal Abscess; Rifampin; Spondylitis; Tomography, X-Ray Computed; Young Adult

Septic-embolic diseases are life threatening; survival critically depends on rapid diagnosis. Clinically, cutaneous manifestations like Janeway lesions are infrequently occurring but highly characteristic. In contrast, histological features are not clearly defined. We report the case of a 59-year-old male patient in deteriorating general condition and fever of unknown origin with lesions suggestive for Janeway lesions. Histology showed dilated blood vessels and extravasated erythrocytes throughout the dermis. Only serial sections revealed single, deep dermal vessels occluded by fibrin thrombi. Computed tomography scan identified multiple pulmonary round masses. Blood cultures showed growth of Staphylococcus aureus and Enterococcus faecalis. The knowledge of the described subtle histological features and a clinical-pathological correlation is essential for the diagnosis of certain cases of septic-embolic conditions.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Blood Vessels; Embolism; Enterococcus faecalis; Gram-Negative Bacterial Infections; Humans; Male; Middle Aged; Sepsis; Skin; Skin Diseases; Staphylococcal Infections