Helena Káčerová

Bio: Helena Káčerová is an academic researcher from Comenius University in Bratislava. The author has contributed to research in topics: Löfgren syndrome & Epidural abscess. The author has an hindex of 1, co-authored 2 publications receiving 2 citations.

COVID-19 mRNA Vaccine–Associated Uveitis Leading to Diagnosis of Sarcoidosis: Case Report and Review of Literature

Abstract: A 34-year-old Japanese person with male gender identity who had been taking intramuscular injection of methyltestosterone depot for 11 years after bilateral mastectomy noticed blurred vision 5 days after the second vaccination for COVID-19 (Tozinameran; Pfizer-BioNTech) in the interval of 3 weeks following the first vaccination. The patient was diagnosed as granulomatous iritis with mutton-fat keratic precipitates and small iris nodules at the pupillary margin in the right eye and began to have 0.1% betamethasone eye drops with good response. The patient, however, continued to have fever and malaise and showed a high level of serum soluble interleukin-2 receptor (sIL-2R) even 4 weeks after the second vaccination. Computed tomographic scan disclosed mediastinal and bilateral hilar small lymphadenopathy together with limited granular lesion in the right lung. Gallium-67 scintigraphy demonstrated high uptake not only in mediastinal and hilar lymph nodes but also in bilateral parotid glands. Right parotid gland biopsy revealed noncaseating granulomas and proved pathological diagnosis of sarcoidosis. The systemic symptoms were relieved by oral prednisolone 20 mg daily. Even though the causal relationship remains undetermined, this case is unique at the point that vaccine-associated uveitis led to the detection of pulmonary lesions and lymphadenopathy, resulting in clinical and pathological diagnosis of sarcoidosis. In literature review, 3 patients showed sarcoidosis-like diseases after COVID-19 vaccination: 2 patients were diagnosed clinically as Lofgren syndrome with acute onset of erythema nodosum and ankle swelling, with or without mediastinal and hilar lymphadenopathy, whereas 1 patient with mediastinal lymphadenopathy but no uveitis was diagnosed pathologically by biopsy as sarcoidosis.

A Rare Case of Lemierre's Syndrome Caused by Streptococcus Intermedius, Presenting as an Epidural Abscess.

Abstract: Lemierre's syndrome is a rare but life-threatening condition characterized by an oropharyngeal infection typically secondary to Fusobacterium necrophorum resulting in septic thrombophlebitis of the internal jugular vein. Streptococcus intermedius is a particularly rare cause of Lemierre's syndrome with only a few cases reported in the literature. Here we describe a rare case of Lemierre's syndrome, caused by Streptococcus intermedius, likely secondary to an odontogenic infection, found to have a cervical epidural abscess with concomitant large retropharyngeal and prevertebral abscesses on presentation, in whom the clinical course was further complicated by an extensive cerebral venous sinus thrombosis. However, despite grave complications, early diagnosis and appropriate emergency management including intravenous antibiotics and surgical intervention led to a successful recovery, thus demonstrating that aggressive measures can potentially lead to a favorable outcome.

Cardiac sarcoidosis and giant cell myocarditis after COVID‐19 infection

Abstract: Patients infected with SARS‐CoV‐2 have varying manifestations of cardiac involvement. We report four patients presenting with symptomatic cardiac sarcoidosis (CS) or giant cell myocarditis (GCM) 1–8 months after mild COVID‐19. All patients received immunosuppressive therapy and improved gradually within the following months. The possible temporal association between the CS/GCM and COVID‐19 infection might suggest that COVID‐19 could be a trigger for granulomatous myocarditis.

Lemierre's syndrome caused by Klebsiella pneumoniae: A case report

Abstract: BACKGROUND Lemierre's syndrome is a disease that causes anaerobic sepsis, internal jugular vein thrombosis, and septic embolism in the lungs and other organs after acute oropharyngeal infection. It was named after Andre-Alfred Lemierre in 1936. CASE SUMMARY Here, we have reported a case of Lemierre's syndrome in a 56-year-old female patient who presented with a sore throat. The patient had septic shock, had not voided, and had severe hyperglycemia at the time of her visit. Imaging tests revealed bilateral pneumonia, pleural effusion, pulmonary embolism, and renal vein thrombosis. The patient was admitted to the intensive care unit and placed on mechanical ventilation due to acute respiratory distress syndrome. Continuous renal replacement therapy was administered to treat renal failure with anuria. Klebsiella pneumoniae was cultured from blood and sputum samples. After reviewing various results, the patient was ultimately diagnosed with Lemierre's syndrome. The patient was treated with appropriate antibiotics and thrombolytic agents. She was discharged from the hospital after recovery. CONCLUSION Lemierre's syndrome is associated with a high mortality rate. Therefore, clinicians should be familiar with the signs and symptoms of this disease as well as the preemptive examinations, procedures, and treatments.

Lemierre's syndrome with cranial epidural abscess complication: A case report

Abstract: Lemierre's syndrome is a rare disease typically manifested by thrombophlebitis of the jugular vein and septic embolism following a history of oropharyngeal infection. Fusobacterium necrophorum is the causative agent of Lemierre syndrome, commonly known as post-anginal sepsis. We reported a 24-year-old male who came to the emergency department complaining of a history of a sore throat, fever, malaise, fever, and neck swelling with a normal consciousness level. A laboratory examination showed leukocytosis and high C-reactive protein serum. Radiological diagnosis reveals an anterior neck abscess with left jugular vein thrombosis and left epidural abscess. The blood culture was positive for Fusobacterium necrophorum. The patient underwent surgical drainage and, at the same time, was treated with antibiotics and anticoagulant drugs. After 45 days, the patient improved clinically and was discharged. There were no other symptoms after a one-month follow-up clinically and neck ultrasonography. Lemierre's syndrome has historically had a high mortality rate, approximately up to 90% before antibiotics. The disease's incidence has declined gradually, leading it to become recognized as the “forgotten disease.” Nevertheless, the incidence of Lemierre syndrome has been increasing over the last twenty to thirty years. Primary oropharyngeal infection, bacteremia, radiographic or clinical evidence of internal jugular vein thrombosis, and septic metastatic foci are the main clinical hallmarks of Lemierre's syndrome. Surgical debridement, antibiotics, and anticoagulants are the treatments of choice. Lemierre's syndrome with cranial epidural abscess is very rare. It is a forgotten disease. Nowadays, the prevalence is increasing. Awareness of clinical and radiological features will aid the prompt management of patients.