PDF(Pubmed)
Abstract：
Lemierre syndrome (LS) is a rare and life-threatening condition predominantly caused by Fusobacterium necrophorum. Currently, there are no standardized clinical guidelines for LS management. Here, we describe the case of a 40-year-old male with fever, productive cough, and dyspnea but no sore throat. Diagnostic radiological examinations revealed multiple pulmonary cavitary nodules and an internal jugular vein occlusion. Metagenomic Next-Generation Sequencing (mNGS) of the alveolar lavage fluid identified Fusobacterium necrophorum, thereby confirming the diagnosis of LS. Intriguingly, the patient exhibited a delayed clinical response despite receiving the appropriate antibiotic. After integrating tigecycline into the treatment to address potential co-infecting bacteria, we observed a marked improvement in his clinical symptoms. Subsequent follow-up over 12 weeks post-discharge revealed complete alleviation of symptoms, and a chest CT scan showed marked regression of the lung lesions.
摘要：
Lemierre综合征（LS）是一种罕见且危及生命的疾病，主要由坏死梭杆菌引起。目前,目前尚无针对LS管理的标准化临床指南.这里,我们描述了一个40岁男性发烧的案例，生产性咳嗽,呼吸困难但没有喉咙痛.诊断性放射学检查显示多个肺空洞结节和颈内静脉阻塞。肺泡灌洗液的宏基因组下一代测序（mNGS）鉴定了坏死梭杆菌，从而确认LS的诊断。有趣的是，尽管接受了适当的抗生素,患者仍表现出延迟的临床反应.在将替加环素整合到治疗中以解决潜在的共同感染细菌后，我们观察到他的临床症状明显改善。出院后12周的后续随访显示症状完全缓解，胸部CT扫描显示肺部病变明显消退。
