A case of lemierre syndrome poorly responsive to medical treatment / 대한내과학회지

Lemierre syndrome is a rare clinical condition that is characterized by anaerobic oropharyngeal infections leading to septic thrombophlebitis of the internal jugular vein and frequent secondary metastatic infections. The accurate diagnosis and treatment, for early stage disease, is important because it may be associated with a high mortality rate if untreated. We present the case of a 34-year-old man who presented with a history of typical for the diagnosis of Lemierre syndrome. Supportive care with antibiotics did not improve the clinical condition. The clinical course improved after treatment with IV anticoagulant and surgical thrombectomy. In addition, he had the antiphospholipid syndrome, which is known to be a common cause of acquired arterial or venous thrombosis. Therefore, in this patient the associated antiphospholipid syndrome might precipitate an internal jugular venous thrombophlebitis after an oropharyngeal infection or might account for the poor response to medical treatment.

Precordial ST-Segment Elevation in Acute Right Ventricular Myocardial Infarction

It is rare to observe ST-segment elevations in the precordial leads that are caused by an occlusion of the right coronary artery and/or its branches. We report here on two cases of acute occlusion of the right coronary artery or its branches that caused acute right ventricular myocardial infarction with ST-segment elevations in the anterior precordial leads. These cases should remind us that the presence of diffuse ST-segment elevations in the precordial leads could be due to acute occlusion of the right coronary artery.