Lemierre Syndrome
Lemierre Syndrome
Fournier Gangrene
Fournier Gangrene
Ultrasound for Abscess Identification
Ultrasound for Abscess Identification
Lemierre Syndrome
Lemierre SyndromeLemierre Syndrome aka Suppurative (septic) thrombophlebitis25yo w/ no PMH had left molar #17 extracted 10days prior, presents with four days of subjective fever, malaise, and increasing pain to L neck and chest (despite Amoxicillin post extraction). BP 88/51, HR 95, Temp 97.7F Pt became tachypneic and hypoxic and was intubated w/ central line placed (not on this side). CT angiogram showed left internal jugular vein thrombosis, low attenuation L temporal lobe concerning for parenchymal abscess. This is usually diagnosed via CT w/ contrast to show filling defect or thrombus, U/S can evaluate the Jugular Vein thrombosis and/or assess for extension of thrombus (this imaging is less useful in regions deep to the clavicle or mandible). Dr. John F. Kilpatrick, Critical Care Ultrasound Education DirectorKings County/SUNY Downstate Department of Emergency Medicine 
Fournier Gangrene
Fournier GangreneA patient presented for worsening, severe scrotal pain.  Point-of-care ultrasound demonstrated a normal appearing testicle with an associated hydrocele.  Significant ring down artifact is visualized posterior producing a “dirty shadow”.  The patient was taken to the operating room where the ring down artifact was confirmed as significant subcutaneous air associated with a necrotizing infection.  By: Michael Schick DO, Emergency Physician  
Ultrasound for Abscess Identification
Ultrasound for Abscess IdentificationA patient with cerebral palsy and quadriplegia presented with her mother for evaluation of a fluctuant mass in her right axilla.  Ultrasound imaging of the mass showed an abscess with multiple septations.  The abscess was incised and drained, and the patient was discharged on antibiotics.Katy Van Donselaar, Emergency Medicine ResidentChristopher Heberer, Emergency Medicine ResidentSimhadri Botta, 4th year Medical Student 
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