RESUMO
A 17 year old male presented with seizures, headache, and fever and left chronic suppurative otitis media. A 35 year old male presented with headache, giddiness, vomiting, pain in eyes, diplopia and right chronic suppurative otitis media. Brain imaging in both revealed thrombosis of lateral and sigmoid sinus and also of internal jugular vein on the left and right side respectively. A diagnosis of Lemierre's syndrome was made in both. They were treated with antibiotics and anticoagulants, and they responded to treatment. We want to report this case as we feel, that with the advent of the antibiotic era, this syndrome has become rare; and so "quite forgotten" or overlooked, by many physicians.
Assuntos
Veias Jugulares/diagnóstico por imagem , Síndrome de Lemierre/diagnóstico , Otite Média Supurativa/diagnóstico , Trombose dos Seios Intracranianos/etiologia , Trombose Venosa/complicações , Abscesso/diagnóstico , Abscesso/tratamento farmacológico , Abscesso/microbiologia , Adolescente , Adulto , Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Audiometria , Ecocardiografia Doppler em Cores , Humanos , Síndrome de Lemierre/tratamento farmacológico , Imageamento por Ressonância Magnética , Masculino , Otite Média Supurativa/tratamento farmacológico , Otite Média Supurativa/microbiologia , Pseudomonas aeruginosa/isolamento & purificação , Trombose dos Seios Intracranianos/diagnóstico , Trombose dos Seios Intracranianos/tratamento farmacológico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Trombose Venosa/diagnóstico , Trombose Venosa/tratamento farmacológicoRESUMO
Rapidly progressive renal failure (RPRF) is an initial clinical diagnosis in patients who present with progressive renal impairment of short duration. The underlying etiology may be a primary renal disease or a systemic disorder. Important differential diagnoses include vasculitis (systemic or renal-limited), systemic lupus erythematosus, multiple myeloma, thrombotic microangiopathy and acute interstitial nephritis. Good history taking, clinical examination and relevant investigations including serology and ultimately kidney biopsy are helpful in clinching the diagnosis. Early definitive diagnosis of RPRF is essential to reverse the otherwise relentless progression to end-stage kidney disease.
