Rare disease
Unusual findings and diagnostic challenges in a child with Lemierre’s disease
1 Leicester Royal Infirmary, Children’s Department, Infirmary Square, Leicester LE1 5WW, UK
2 Leicester Royal Infirmary, Clinical Microbiology, Infirmary Square, Leicester LE1 5WW, UK
3 Leicester Royal Infirmary, Otorhinolaryngology, Infirmary Square, Leicester LE1 5WW, UK
Correspondence to:
Florian Gahleitner, florian.gahleitner{at}doctors.net.uk
16S rDNA polymerase chain reaction (PCR) in the diagnosis of fastidious organisms is becoming increasingly commonplace. We present the case of a child admitted to an acute paediatric unit of a university teaching hospital with otorrhoea, torticollis, and cervical lymphadenopathy. Examination revealed hepatosplenomegaly associated with pancytopenia. Radiological imaging confirmed a retropharyngeal abscess, bilateral mastoiditis, cerebellar lesions, and venous sinus thrombosis. Swabs of aural discharge grew anaerobes. Drainage of the retropharyngeal abscess and bilateral mastoidectomy were performed. Bone marrow aspiration was initially suspicious of acute leukaemia prompting further investigations, but cytogenetic analysis ruled out this diagnosis and changes were attributed to severe sepsis. Following 27 days of intravenous antibiotics and after clinical improvement, clindamycin was started. Intraoperative pus yielded no significant pathogens. A 16S rDNA PCR confirmed Fusobacterium necrophorum. The boy was discharged on a 6 week course of oral clindamycin.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Add article to my folders
- Download to citation manager
- Request Permissions
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full text of all Editor's Choice articles and summaries of every article are free without registration
The full text of Images in ... articles are free to registered users
Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource
Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog
