PDF(Pubmed)
Abstract：
BACKGROUND: Given the widespread prevalence of the coronavirus disease 2019 (COVID-19), oral and neck examinations tend to be avoided in patients with suspected or confirmed COVID-19. This might delay the diagnosis of conditions such as Lemierre\'s syndrome, which involves symptoms resembling COVID-19-related throat manifestations.
METHODS: A 24-year-old man without any underlying conditions was diagnosed with COVID-19 7 days before presentation. He was admitted to another hospital 1 day before presentation with severe COVID-19 and suspected bacterial pneumonia; accordingly, he was started on treatment with remdesivir and meropenem. Owing to bacteremic complications, the patient was transferred to our hospital for intensive care. On the sixth day, the patient experienced hemoptysis; further, a computed tomography (CT) scan revealed new pulmonary artery pseudoaneurysms. Successful embolization was performed to achieve hemostasis. In blood cultures conducted at the previous hospital, Fusobacterium nucleatum was isolated, suggesting a cervical origin of the infection. A neck CT scan confirmed a peritonsillar abscess and left internal jugular vein thrombus; accordingly, he was diagnosed with Lemierre\'s syndrome. The treatment was switched to ampicillin/sulbactam, based on the drug susceptibility results. After 6 weeks of treatment, the patient completely recovered without complications.
CONCLUSIONS: This case highlights the significance of thorough oral and neck examinations in patients with suspected or diagnosed COVID-19 for the detection of throat and neck symptoms caused by other conditions.
METHODS: A 24-year-old man without any underlying conditions was diagnosed with COVID-19 7 days before presentation. He was admitted to another hospital 1 day before presentation with severe COVID-19 and suspected bacterial pneumonia; accordingly, he was started on treatment with remdesivir and meropenem. Owing to bacteremic complications, the patient was transferred to our hospital for intensive care. On the sixth day, the patient experienced hemoptysis; further, a computed tomography (CT) scan revealed new pulmonary artery pseudoaneurysms. Successful embolization was performed to achieve hemostasis. In blood cultures conducted at the previous hospital, Fusobacterium nucleatum was isolated, suggesting a cervical origin of the infection. A neck CT scan confirmed a peritonsillar abscess and left internal jugular vein thrombus; accordingly, he was diagnosed with Lemierre\'s syndrome. The treatment was switched to ampicillin/sulbactam, based on the drug susceptibility results. After 6 weeks of treatment, the patient completely recovered without complications.
CONCLUSIONS: This case highlights the significance of thorough oral and neck examinations in patients with suspected or diagnosed COVID-19 for the detection of throat and neck symptoms caused by other conditions.
摘要：
背景：鉴于2019年冠状病毒病（COVID-19）的广泛流行，疑似或确诊COVID-19的患者倾向于避免进行口腔和颈部检查。这可能会延迟Lemierre综合征等疾病的诊断，这涉及类似于COVID-19相关喉咙表现的症状。
方法：一名24岁无任何潜在疾病的男子在就诊前7天被诊断为COVID-19。他在出现严重的COVID-19和疑似细菌性肺炎前1天被送往另一家医院；他开始接受雷姆德西韦和美罗培南的治疗。由于菌血症并发症，病人被转移到我们医院接受重症监护。第六天,患者出现咯血；进一步，计算机断层扫描（CT）扫描显示新的肺动脉假性动脉瘤。成功进行栓塞以实现止血。在以前医院进行的血液培养中，分离出核梭杆菌,提示感染的来源是宫颈.颈部CT扫描证实扁桃体周围脓肿和左颈内静脉血栓；因此，他被诊断出患有Lemierre综合征.治疗改用氨苄西林/舒巴坦，根据药敏结果。治疗6周后,患者完全康复，无并发症。
结论：该病例强调了对疑似或诊断为COVID-19的患者进行彻底的口腔和颈部检查对于检测其他疾病引起的咽喉和颈部症状的重要性。
方法：一名24岁无任何潜在疾病的男子在就诊前7天被诊断为COVID-19。他在出现严重的COVID-19和疑似细菌性肺炎前1天被送往另一家医院；他开始接受雷姆德西韦和美罗培南的治疗。由于菌血症并发症，病人被转移到我们医院接受重症监护。第六天,患者出现咯血；进一步，计算机断层扫描（CT）扫描显示新的肺动脉假性动脉瘤。成功进行栓塞以实现止血。在以前医院进行的血液培养中，分离出核梭杆菌,提示感染的来源是宫颈.颈部CT扫描证实扁桃体周围脓肿和左颈内静脉血栓；因此，他被诊断出患有Lemierre综合征.治疗改用氨苄西林/舒巴坦，根据药敏结果。治疗6周后,患者完全康复，无并发症。
结论：该病例强调了对疑似或诊断为COVID-19的患者进行彻底的口腔和颈部检查对于检测其他疾病引起的咽喉和颈部症状的重要性。
