amoxicillin-potassium-clavulanate-combination and Mediastinitis

Lemierre syndrome is a rare but serious illness that associates throat infection and thrombosis of the internal jugular vein (IJV) or one of its tributaries with subsequent distant septic emboli. The purpose of our study was to review the pathogenesis, clinical presentation, and treatment of this disease.. Patients with confirmed Lemierre syndrome were included in our retrospective monocentric study. All patients had bacteriologic analyses as well as radiologic imaging.. There were 11 patients in our study (from 1998-2012). Fusobacterium necrophorum was responsible for the infection in 45% of cases. Surgical drainage of pharyngeal, cervical, or mediastinal abscesses was carried out in 8 cases. All patients received broad-spectrum antibiotics. Six patients were admitted to the intensive care unit (ICU). One patient (9%) died.. Treatment with broad-spectrum antibiotics is the primary choice of treatment of Lemierre syndrome. Surgery is indicated in case of abscess formation.

Topics: Abscess; Adolescent; Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anticoagulants; Ceftriaxone; Cellulitis; Drainage; Female; Humans; Intensive Care Units; Lemierre Syndrome; Length of Stay; Male; Mediastinitis; Metronidazole; Middle Aged; Retrospective Studies; Tonsillitis; Young Adult

Adjuvant chemotherapy for breast cancer, although generally safe and of proven benefit, can have severe complications. Central venous catheter (CVC) complications are relatively common forms of treatment-related morbidity in this setting. We report a rare type of CVC-related complication, that of chemotherapy-induced mediastinitis from central venous extravasation of the drug vinblastine, in a women undergoing adjuvant chemotherapy. The patient presented with signs and symptoms consistent with mediastinitis, but the diagnosis was delayed because the initial findings were nonspecific and there was little suspicion for a CVC-related problem. A radionuclide venous flow study was misleading, but a computed tomographic study of the chest and contrast venography confirmed the diagnosis. Conservative treatment with CVC removal, systemic anticoagulation, antibiotics, and pain controlled to gradual improvement in the patient's clinical status. More aggressive strategies, such as thrombolytic therapy and surgical intervention, were considered, but these approaches have not been used in this particular setting. The complication reported here is the first described in the literature in an adult patient. Two similar cases have been reported in pediatric patients. It is likely that this clinical problem is underreported. Patients with CVCs actively undergoing chemotherapy with vesicant agents should be watched carefully for early signs of CVC disruption and subsequent extravasation, as it is likely that early intervention will be of benefit.

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Analgesics, Opioid; Anticoagulants; Antineoplastic Agents, Phytogenic; Breast Neoplasms; Catheterization, Central Venous; Chemotherapy, Adjuvant; Clavulanic Acids; Contrast Media; Dextropropoxyphene; Drug Therapy, Combination; Extravasation of Diagnostic and Therapeutic Materials; Female; Humans; Mediastinitis; Middle Aged; Radionuclide Imaging; Subclavian Vein; Thrombosis; Tomography, X-Ray Computed; Vinblastine; Warfarin

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Fusobacterium Infections; Fusobacterium necrophorum; Humans; Male; Mediastinitis; Osteomyelitis; Sternum

Exudative pericarditis, and in particular a purulent type, is a rare condition which requires emergency medical intervention. In our paper we present a case report concerning a patient with purulent pericarditis.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Inflammatory Agents, Non-Steroidal; Carbazoles; Carvedilol; Diuretics; Drainage; Echocardiography; Fatal Outcome; Furosemide; Humans; Hydrochlorothiazide; Infusions, Intravenous; Male; Mediastinitis; Middle Aged; Pericarditis; Propanolamines; Sclerosis; Spironolactone; Suppuration; Vitamin K

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Deglutition Disorders; Drainage; Dysphonia; Fasciitis, Necrotizing; Humans; Male; Mediastinitis; Neck; Streptococcal Infections; Streptococcus constellatus; Tomography, X-Ray Computed

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Combined Modality Therapy; Diagnosis, Differential; Dyspnea; Emergencies; Esophageal Neoplasms; Esophageal Stenosis; Fever of Unknown Origin; Fusobacterium Infections; Humans; Male; Mediastinitis; Streptococcal Infections; Streptococcus anginosus; Therapeutic Irrigation; Tomography, X-Ray Computed