Case Report
Volume: 4 | Issue: 3 | Published: Mar 22, 2020 | Pages: 88 - 92 | DOI: 10.24911/ejmcr/173-1544793661
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
Article Info
Authors
Quah Wy Jin
Department of Medicine, Miri Hospital, Sarawak, Malaysia
Y. L. Wong
Department of Radiology, Miri Hospital, Sarawak, Malaysia
Norazila BT Naiem
Department of Medicine, Miri Hospital, Sarawak, Malaysia
Mohd Syafwan B Mohd Soffian
Department of Otorhinolaryngology, Miri Hospital, Sarawak, Malaysia
Publication History
Received: December 14, 2018
Revised: February 23, 2020
Accepted: March 06, 2020
Published: March 22, 2020
Abstract
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, green
