Med Clin Barcelona
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Septic thrombophlebitis of the jugular vein (Lemierre's syndrome) is a severe complication of oropharyngeal infections. The extension of the infection to the cardiovascular system favors its dissemination to the lung and, eventually, to other points in the organism. We report two cases of Lemierre's syndrome seen in a 10-year period. The diagnostic and therapeutic aspects are particularly emphasized so as to stimulate the knowledge of this uncommon condition.
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We have prospectively evaluated 16 episodes of bacteremia induced by decubitus ulcers. The most commonly isolated microorganisms were Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa and Bacteroides fragilis. Bacteremia was polymicrobial in 5 cases (31%). ⋯ The initial antibiotic therapy was satisfactory in 13 cases. Mortality rate directly associated with bacteremia was 18%, but the overall mortality rate was 62%. We did not identify data permitting a reliable prediction of the findings of blood culture; therefore, the initial empirical therapy should be active against Staphylococcus aureus, Pseudomonas, enteric Gram-negative bacilli and anaerobes including Bacteroides fragilis.