Clinical medicine (London, England)
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Case Reports
Not always as simple as a UTI: An atypical case of Lemierre's syndrome, the forgotten disease.
A 65-year-old man, who was previously fit and well with no known medical comorbidities, was admitted with symptoms of dysuria, urinary frequency, pyrexia, chills and lethargy. His vitals showed that he was hypotensive, tachycardic and pyrexial. Urine dip was heavily positive for leukocytes and nitrites and had markedly elevated inflammatory markers and mild acute kidney injury. ⋯ The patient was continued on intravenous piperacillin/tazobactam and metronidazole as per sensitivities and later switched to oral metronidazole. He was initiated on warfarin anticoagulation. He made a remarkable recovery and was discharged with outpatient ear, nose and throat and haematology follow-up.
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The Royal College of Physicians' COVID-19 study was conducted in 2020 as a collaboration of 19 English NHS trusts, the Association of Professional Healthcare Analysts and a data team in the Institute of Global Health Innovation at Imperial College London. The participating trusts had a combined catchment population of 10.46 million and looked after over 26,000 patients with SARS-CoV-2. The study involved 510 patient cases the majority of which were mortality reviews. ⋯ Poor care was uncommon. Qualitative data generated 24 common themes that were articulated by the creation of nine vignettes (four explored here). Six recommendations were created, and further analysis of specific recommendations is advised.