Lemierre´s syndrome: descending necrotizing mediastinitis

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Lemierre´s syndrome is a rare but serious infection caused by bacteria attacking the lymph nodes of the neck and causing blood clots to form in the large veins of the neck, whereas mediastinistis is an acute inflammation of the mediastinum.1,2 The presence of enlarged lymph nodes in the mediastinum on an X-ray of the lungs or a CT of the thorax leads to the diagnosis. In this case report we describe the case of 40-year-old patient who was admitted to the Cardiology Department of the Sibenik General Hospital due to swelling and pain in the left side of the neck, as well as fever. The course of the patient’s stay in Sibenik General Hospital, as well as the transfer and course of the patient’s stay in University Hospital Centre Split, where the patient was transferred due to disturbed general condition, hemodynamic instability, and worsening of inflammatory parameters, is shown. All diagnostic procedures for determining the cause of the patient’s condition, as well as all therapeutic procedures, are also discussed. Deep vein thrombosis of the cephalic vein, pericardium effusion, and bilateral pleural effusion were all confirmed by diagnostic tests. Can we say with certainty that the resulting clinical picture is post-COVID-19 because the patient overcame a moderate clinical picture of SARS-CoV-2 virus infection a month before the onset of these symptoms? (English) [ABSTRACT FROM AUTHOR] Lemierrov sindrom je rijetka, ali ozbiljna infekcija kada bakterije napadaju limfne cvorove vrata, a krvni ugrusci nastaju u velikim venama vrata, dok je medijastinistis akutna upala medijastinuma.1,2 Dijagnoza pociva na nalazu povecanih limfnih cvorova u medijastinumu na RTG-u pluca ili CT-u toraksa. U ovom radu prikazujemo 40-godisnju bolesnicu koja je zaprimljena na Odjel kardiologije Opce bolnice Sibenik zbog otoka i boli u lijevoj strani vrata i febriliteta. Prikazan je tijek boravka u OB Sibenik, te premjestaj i tijek boravka u Klinickom bolnickom centru Split gdje je zbog narusenog opceg stanja, hemodinamske nestabilnosti uz pogorsanje upalnih parametara bolesnica premjestena. Također su prikazani dijagnosticki postupci u otkrivanju uzroka nastalog stanja, kao i svi terapijski postupci. Dijagnostickim pretragama verificirana je duboka venska tromboza vene cephalice, perikardijalni izljev te obostrani pleuralni izljevi. Buduci da je bolesnica preboljela srednje tesku sliku infekcije SARS-CoV-2 virusom mjesec dana prije pojave navedenih tegoba, možemo li sa sigurnoscu reci da je nastala klinicka slika zapravo nakon COVID-19 infekcije? (Croatian) [ABSTRACT FROM AUTHOR] Copyright of Cardiologia Croatica is the property of Croatian Cardiac Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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