Lemierre's Like Syndrome: Retropharyngeal Abscess With Internal Jugular and Cerebral Venous Thromboses and Septic Embolization Leading to Pulmonary Embolism and Cerebral Abscesses Complicated by Papilledema and Residual Sixth Cranial Nerve Palsy.

Lemierre 样综合征 ： 咽后脓肿伴颈内静脉和脑内静脉血栓和败血症栓塞 ， 导致肺栓塞和脑脓肿并伴有乳头水肿和残余第六脑神经麻痹。

• 发表时间: 2024 Mar
• 来源期刊: Cureus
• DOI: 10.7759/cureus.56250
• PMID: 38623115
• 文章类型: Case Reports
• 作者列表: Ranganath S

关键词: cerebral abscess; cerebral venous thrombosis; exotropia; jugular venous thrombosis; lalls; lemierre's and lemierre's like syndrome; retropharyngeal abscess; septic embolism; sixth cranial nerve palsy; streptococcus intermedius

Abstract

A male child with a history of sinusitis presented to the emergency medicine department with a high fever, neck swelling, headache, vomiting, and double vision. He was diagnosed with retropharyngeal abscess (RPA) with bilateral internal jugular vein (IJV) and cerebral venous thromboses. The child was treated promptly and transferred to a specialty center, where the abscess was drained. However, he developed papilledema and septic embolism, leading to pulmonary embolism and cerebral abscesses. The child was an inpatient for six weeks and had outpatient treatment for three months. He developed exotropia due to bilateral sixth cranial nerve palsy. This existed even at the 24-month follow-up. This case report highlights the rare complications and morbidity from the retropharyngeal abscess. It also emphasizes the early diagnosis and management options in a busy emergency medicine department.

摘要

一名有鼻窦炎病史的男童高烧到急诊科就诊，颈部肿胀,头痛,呕吐,双重视觉。他被诊断为咽后脓肿（RPA）伴双侧颈内静脉（IJV）和脑静脉血栓形成。孩子得到了及时的治疗，并被转移到专科中心，脓肿被引流的地方.然而,他出现了乳头水肿和脓毒性栓塞,导致肺栓塞和脑脓肿.这个孩子住院六周，门诊治疗三个月。由于双侧第六颅神经麻痹，他发展了外斜视。即使在24个月的随访中也存在这种情况。该病例报告强调了咽后脓肿的罕见并发症和发病率。它还强调了繁忙的急诊医学部的早期诊断和管理选择。