Septic thrombosis of the axillary vein with unilateral pulmonary abscess. Variation of Lemierre's syndrome

摘要

HISTORY: A man aged 62 was hospitalized for treatment of an axillary abscesses originating from a suppurative hidradenitis. INVESTIGATIONS: Microbiological tests revealed peptostreptococcus and staphylococci. Hepatic enzymes were moderately elevated in association with a mild hyperbilirubinemia. RESULTS: After surgical intervention the patient developed a severe septic illness together with a unilateral pulmonary infection and abscess formation, requiring a thoracotomy. Preoperative serology ruled out active hepatitis as well as atypical pneumonia. The detection of a unilateral septic axillary thrombosis led to the correct diagnosis. Antibiotics and anticoagulation brought about a complete cure. CONCLUSION: In cases of septicemia of uncertain origin septic venous thromboses should be considered in the differential diagnosis.