著者

深川 智恵 古土井 春吾 高橋 英哲 山田 周子 渋谷 恭之 古森 孝英

出版者

社団法人 日本口腔外科学会

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.56, no.10, pp.605-608, 2010-10-20 (Released:2013-10-31)

参考文献数

9

被引用文献数

1

---

Lemierre syndrome is a potentially life-threatening disease caused by an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein, frequently associated with abscess formation in distant organs.We report the case of a 78-year-old woman who received surgical therapy, chemotherapy, and radiation therapy for malignant lymphoma in 2001. She visited our hospital because of a swelling and pain of the left submandibular region in August 2009. The patient was immediately hospitalized to control the pain and infection. PET images showed tracer uptake in the lung. Bilateral multiple septic emboli of the thorax were detected on CT. On the basis of these findings, Lemierre syndrome was diagnosed. The patient was treated with antibiotics intravenously, and surgical drainage was performed. All symptoms improved, and she was discharged after 32 days.

著者

重田 崇至 梅田 正博 吉武 賢 高橋 英哲 澁谷 恭之 古森 孝英 井堂 信二郎 長谷川 巧実 李 進彰

出版者

Japanese Stomatological Society

雑誌

日本口腔科学会雑誌 (ISSN:00290297)

巻号頁・発行日

vol.61, no.1, pp.1-7, 2012 (Released:2012-03-08)

参考文献数

33

---

It has been recommended recently that patients receiving anticoagulant therapy should undergo dental extraction without discontinuation of anticoagulant drugs in consideration of the risk of thromboembolism, but the frequency of hemorrhagic complications has not been well documented. A retrospective study of 282 patients who underwent dental extraction under continuous warfarin therapy was performed.Twenty-two of the 282 patients (8.9%) showed postoperative hemorrhages: 14 of 168 (8.3%) in those receiving administration of warfarin alone, and 11 of 114 (9.6%) in those receiving administration of both warfarin and antiplatelet drugs. Most of the hemorrhages occurred within 2 days after the extraction. The rate of postoperative hemorrhage was 5.7% in those with prothrombin time International Normalized Ratio (PT-INR) of 1.49 or lower, 12.5% in those with PT-INR of 1.5-1.99, 12.8% in those with PT-INR of 2.0-2.99, and 16.7% in those with PT-INR of 3.0 or higher, although there was no significant difference between PT-INR and frequency of postoperative hemorrhage. All patients showing postoperative hemorrhage were treated successfully by local procedures such as suturing or application of cellulose oxide gauze. These findings suggest that dental extraction can be safely done without discontinuation of warfarin therapy.