A rare case of Achromobacter Xylosoxidans infection presenting as Lemierre's syndrome complicated with bilateral lung empyema in a young boy
Authors: Quah Wy Jin, Y L Wong, Norazila BT Naiem, Mohd Syafwan B Mohd Soffian
Background: In the recent decades, Lemierre's syndrome (LS) has been increasingly diagnosed with a wide range of causative organisms, especially with increased awareness of such an entity. Case Presentation: We report an unusual case of LS in a previously healthy 15-year-old boy who presented initially with high grade fever, nonspecific gastrointestinal symptoms, and unilateral purulent otorrhea. Patient subsequently deteriorated requiring intensive care and exhibited altered mental status prompting an urgent contrast enhanced computed tomography brain which clinched the diagnosis. Patient underwent mastoidectomy followed by IV antibiotics that were streamlined according to his pus culture. He also developed bilateral lung empyema requiring bilateral chest tube drainage. Anticoagulation was commenced for the thrombosis and patient was discharged home well. Conclusion: This was an intriguing case in view of the unusual organism causing LS, initial diagnostic dilemma, and challenges in management.
Keywords: Achromobacter Xylosoxidans, Lemierre syndrome, IJV thrombosis, leptospirosis, lung empyema, case report
Authors
Correspondence to:
Quah Wy Jin, Department of Medicine, Miri Hospital, Sarawak, Malaysia kalel_88@hotmail.com
Publication history:
Received 14 Dec 2018
Revised 23 Feb 2020
Accepted 06 Mar 2020
Published online 22 Mar 2020
Published in print 04 Apr 2020
Jin QW, Wong YL, Naiem NB, Soffian MSBM. A rare case of Achromobacter Xylosoxidans infection presenting as Lemierre's syndrome complicated with bilateral lung empyema in a young boy. EJMCR. 2020; 4(3): 88-92. doi:
10.24911/ejmcr/173-1544793661
Jin QW, Wong YL, Naiem NB, Soffian MSBM. A rare case of Achromobacter Xylosoxidans infection presenting as Lemierre's syndrome complicated with bilateral lung empyema in a young boy. https://www.ejmcr.com/?mno=21585 [Access: April 20, 2024]. doi:
10.24911/ejmcr/173-1544793661
Jin QW, Wong YL, Naiem NB, Soffian MSBM. A rare case of Achromobacter Xylosoxidans infection presenting as Lemierre's syndrome complicated with bilateral lung empyema in a young boy. EJMCR. 2020; 4(3): 88-92. doi:
10.24911/ejmcr/173-1544793661
Jin QW, Wong YL, Naiem NB, Soffian MSBM. A rare case of Achromobacter Xylosoxidans infection presenting as Lemierre's syndrome complicated with bilateral lung empyema in a young boy. EJMCR. (2020), [cited April 20, 2024]; 4(3): 88-92. doi:
10.24911/ejmcr/173-1544793661
Jin, Q. W., Wong, . Y. L., Naiem, . N. B. & Soffian, . M. S. B. M. (2020) A rare case of Achromobacter Xylosoxidans infection presenting as Lemierre's syndrome complicated with bilateral lung empyema in a young boy. EJMCR, 4 (3), 88-92. doi:
10.24911/ejmcr/173-1544793661
Jin, Quah Wy, Y. L. Wong, Norazila BT Naiem, and Mohd Syafwan B Mohd Soffian. 2020. A rare case of Achromobacter Xylosoxidans infection presenting as Lemierre's syndrome complicated with bilateral lung empyema in a young boy. European Journal of Medical Case Reports, 4 (3), 88-92. doi:
10.24911/ejmcr/173-1544793661
Jin, Quah Wy, Y. L. Wong, Norazila BT Naiem, and Mohd Syafwan B Mohd Soffian. "A rare case of Achromobacter Xylosoxidans infection presenting as Lemierre's syndrome complicated with bilateral lung empyema in a young boy." European Journal of Medical Case Reports 4 (2020), 88-92. doi:
10.24911/ejmcr/173-1544793661
Jin, Quah Wy, Y. L. Wong, Norazila BT Naiem, and Mohd Syafwan B Mohd Soffian. "A rare case of Achromobacter Xylosoxidans infection presenting as Lemierre's syndrome complicated with bilateral lung empyema in a young boy." European Journal of Medical Case Reports 4.3 (2020), 88-92. Print. doi:
10.24911/ejmcr/173-1544793661
Jin, Q. W., Wong, . Y. L., Naiem, . N. B. & Soffian, . M. S. B. M. (2020) A rare case of Achromobacter Xylosoxidans infection presenting as Lemierre's syndrome complicated with bilateral lung empyema in a young boy. European Journal of Medical Case Reports, 4 (3), 88-92. doi:
10.24911/ejmcr/173-1544793661
