ABSTRACT
Fusobacterium necrophorum is a well-known cause of Lemierre's syndrome. Recent studies suggest a causative association between F. necrophorum and acute appendicitis. We present a case of a 15-year-old previously healthy girl who presented with acute non-perforated appendicitis, intra-abdominal abscesses and thrombosis that led to omental necrosis. This resulted in a life-threatening septic shock with the need for prolonged intensive care. We suggest that F. necrophorum identified in pus from the abdomen caused this fulminant variation of appendicitis with findings similar to those seen with Lemierre's syndrome.
Subject(s)
Appendicitis/microbiology , Fusobacterium Infections/complications , Abdominal Abscess/microbiology , Abdominal Abscess/therapy , Adolescent , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Appendicitis/surgery , Critical Illness , Female , Fusobacterium Infections/drug therapy , Fusobacterium necrophorum/isolation & purification , Humans , Necrosis/microbiology , Necrosis/surgery , Omentum/microbiology , Omentum/pathology , Omentum/surgery , Shock, Septic/microbiology , Shock, Septic/therapyABSTRACT
Enhanced external counterpulsation (EECP) is known to reduce angina pectoris in patients in whom revascularization is not possible. The therapy is associated with few adverse effects. A case with a previously unknown complication - toxic shock syndrome - that occurred twice in an EECP-treated patient is described. Toxic shock syndrome initially resembles the state of septic shock. Early recognition of the syndrome and initiation of therapy is of vital importance to prevent rapid progression and a possibly fatal outcome. Awareness of this condition among cardiologists offering EECP is essential.
