What is it? a septic thrombus of the jugular vein.
Which bacteria are implicated? usually oral flora, and typically Fusobacterium species.
How does one get it? after a pharyngitis, there may be a small abscess or erosion of the mucosa. Bacteria can then invade the peri-pharyngeal space which houses the carotid sheath (encasing the jugular vein), and neck musculature.
How do patients present? typically younger patients with a prodrome of a sore throat present with fever, and possibly tenderness over the thrombosed vein. Septic emboli frequently spread to the lungs so an element of respiratory distress may be seen.
Treatment? use a beta-lactamase resistant beta-lactam. Surgical exploration may be required. The role of anticoagulation is controversial.
A great reference: http://content.nejm.org/cgi/content/full/350/10/1037
Have a great day.
Which bacteria are implicated? usually oral flora, and typically Fusobacterium species.
How does one get it? after a pharyngitis, there may be a small abscess or erosion of the mucosa. Bacteria can then invade the peri-pharyngeal space which houses the carotid sheath (encasing the jugular vein), and neck musculature.
How do patients present? typically younger patients with a prodrome of a sore throat present with fever, and possibly tenderness over the thrombosed vein. Septic emboli frequently spread to the lungs so an element of respiratory distress may be seen.
Treatment? use a beta-lactamase resistant beta-lactam. Surgical exploration may be required. The role of anticoagulation is controversial.
A great reference: http://content.nejm.org/cgi/content/full/350/10/1037
Have a great day.
No comments :
Post a Comment