Lemierre’s Syndrome

Lemierre 综合征
  • 文章类型: Journal Article
    背景:Lemierre综合征是一种致命且罕见的疾病,通常以口咽部感染和颈内静脉血栓形成为特征。及时使用适当的抗生素是标准治疗方法。
    方法:作者报告一例Lemierre综合征。一名67岁的中国汉族男性患者患有巨大的炎性颈部肿块,涉及左颈内静脉血栓形成,诊断为Lemierre综合征,最终通过手术治疗治愈。此外,通过PubMed进行了文献综述,使用术语“Lemierre综合征/疾病和综述,荟萃分析或回顾性研究“和”Lemierre综合征/疾病和颈内静脉“。这次搜索产生了六篇记录手术方法的文章,例如引流,开颅手术,拔牙,和闭塞静脉的结扎,为临床医生提供更多关于Lemierre综合征治疗的想法。
    结论:这是第一个总结手术治疗条件的综述。此外,这是首次报道如此大的炎性颈部肿块,通过手术切除和颈内静脉结扎术完全治愈。作者还首次就Lemierre综合征的手术干预提供了一些结论。
    BACKGROUND: Lemierre\'s syndrome is a fatal and rare disease that is typically characterized by oropharyngeal infection and internal jugular vein thrombosis. Timely institution of appropriate antibiotics is the standard treatment.
    METHODS: The authors report a case of Lemierre\'s syndrome. A 67-year-old male patient of Han ethnicity in China suffered from a large inflammatory neck mass involving left internal jugular vein thrombosis diagnosed as Lemierre\'s syndrome and finally cured by surgical treatment. In addition, a literature review was carried out through PubMed using the terms \"Lemierre\'s syndrome/disease and review, meta-analysis or retrospective study\" and \"Lemierre\'s syndrome/disease and internal jugular vein\". This search yielded six articles that recorded surgical methods such as drainage, craniotomy, tooth extraction, and ligation of the occluded vein to give clinicians more ideas about the treatment of the Lemierre\'s syndrome.
    CONCLUSIONS: This is the first review to summarize the conditions under which surgical treatment are conducted. Additionally, this is the first report of such a large inflammatory neck mass that was completely cured by surgical resection and internal jugular vein ligation. The authors also offer several conclusions regarding surgical intervention in Lemierre\'s syndrome for the first time.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:Lemierre综合征是一种罕见的,以颈内静脉化脓性血栓性静脉炎为特征的口咽感染的潜在致命并发症。它主要影响健康的青少年和年轻人。它的发病率在抗生素时代之后下降,但它可能在最近几十年里重新崛起,可能是由于谨慎使用抗生素和增加细菌耐药性。及时的诊断和治疗是必要的,以防止显著的发病率和死亡率。
    方法:Lemierre综合征被称为“被遗忘的疾病,“报告的发病率约为每百万3.6例。演示时的平均年龄约为20岁,它可以发生在任何年龄。Lemierre综合征伴随着口咽感染,最常见的咽炎,导致颈内静脉化脓性血栓性静脉炎。F.坏死是典型的病原体,尽管其他生物越来越被隔离。转移性感染,尤其是肺,是常见的并发症。颈部CT造影证实颈内静脉血栓形成是诊断的金标准。覆盖厌氧菌的长期广谱IV抗生素是该疾病治疗的主要手段。也可以考虑抗凝。不治疗死亡率很高,但大多数患者通过适当的治疗完全康复。
    结论:Lemierre综合征应在伴有单侧颈部肿胀和发热的长期咽炎患者中被怀疑。早期诊断和及时抗生素治疗是关键,考虑到如果不治疗可能会带来灾难性的结果。对Lemierre综合征的认识提高有助于其及时管理。
    BACKGROUND: Lemierre syndrome is a rare, potentially fatal complication of oropharyngeal infections characterized by septic thrombophlebitis of the internal jugular vein. It primarily affects healthy adolescents and young adults. Its incidence declined after the antibiotic era, but it may have resurged in recent decades, likely due to judicious antibiotic use and increasing bacterial resistance. Prompt diagnosis and treatment are imperative to prevent significant morbidity and mortality.
    METHODS: Lemierre syndrome has been called \"the forgotten disease,\" with a reported incidence of around 3.6 cases per million. The mean age at presentation is around 20 years old, though it can occur at any age. Lemierre Syndrome follows an oropharyngeal infection, most commonly pharyngitis, leading to septic thrombophlebitis of the internal jugular vein. F. necrophorum is the classic pathogen, though other organisms are being increasingly isolated. Metastatic infections, especially pulmonary, are common complications. Contrast-enhanced CT of the neck confirming internal jugular vein thrombosis is the gold standard for diagnosis. Long-course broad-spectrum IV antibiotics covering anaerobes are the mainstays of the disease\'s treatment. Anticoagulation may also be considered. Mortality rates are high without treatment, but most patients recover fully with appropriate therapy.
    CONCLUSIONS: Lemierre syndrome should be suspected in patients with prolonged pharyngitis followed by unilateral neck swelling and fevers. Early diagnosis and prompt antibiotic therapy are key, given the potential for disastrous outcomes if untreated. An increased awareness of Lemierre syndrome facilitates its timely management.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    Lemierre综合征,也被称为厌氧性心绞痛后败血症,坏死菌病,和“被遗忘的疾病”,“这是一种罕见的表现。它经常表现为败血症,喉咙痛,发烧,颈部疼痛,颈内静脉血栓性静脉炎/血栓形成,和脓毒性栓子.通常与疾病相关的细菌是梭杆菌属,但它也与葡萄球菌有关,链球菌,和其他细菌物种。Lemierre综合征的诊断是基于化脓性血栓性静脉炎的证据,在口咽感染之前,积极的文化。治疗通常包括针对病原体的抗生素。抗凝的使用,虽然有争议,被几项研究证明是有益的。我们描述了一个出现喉咙痛的中年患者,颈部疼痛,和吞咽困难.颈部和胸部的成像显示右颈静脉血栓形成以及肺部的败血症栓子。从扁桃体周围脓肿中排出的血液和脓液的培养物生长出了硬化链球菌。在这项研究中,我们已经说明了用抗生素有效管理Lemierre综合征,抗凝剂,和针吸脓肿。
    Lemierre\'s syndrome, also known as anaerobic post-anginal septicemia, necrobacillosis, and the \"forgotten disease,\" is a rare manifestation. It is often presented with sepsis, sore throat, fever, neck pain, internal jugular vein thrombophlebitis/thrombosis, and septic emboli. The bacteria that are usually associated with the disease are Fusobacterium species, but it is also associated with Staphylococcus, Streptococcus, and other bacterial species. The diagnosis of Lemierre\'s syndrome is made based on evidence of septic thrombophlebitis, preceding oropharyngeal infection, and positive culture. Treatment usually consists of antibiotics directed toward the causative organism. The use of anticoagulation, although controversial, is shown to be beneficial by several studies. We describe a middle-aged patient who presented with a sore throat, neck pain, and dysphagia. Imaging of the neck and chest revealed right jugular thrombosis along with septic emboli in the lungs. The culture of the blood and pus drained from the peritonsillar abscess grew Streptococcus anginosus. In this study, we have illustrated the effective management of Lemierre\'s syndrome with antibiotics, anticoagulants, and needle aspiration of abscess.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    Lemierre综合征是一种罕见的,急性口咽感染的危及生命的并发症。它通常以继发于坏死梭杆菌的咽炎为特征,引起颈内静脉血栓性静脉炎和败血症,随后形成脓毒性栓子,可以迅速扩散到不同的器官部位。如果延迟使用抗生素治疗,这种情况与高死亡率有关,最近的证据表明,患者在院内发病和长期神经系统后遗症的风险很大。尽管人们一致认为抗生素是治疗的主要手段,目前对于在这种情况下使用抗凝药物尚无共识。这篇综述文章旨在总结我们目前对Lemierre综合征定义的理解,流行病学,微生物学,介绍,诊断,和治疗。
    Lemierre\'s syndrome is a rare, life-threatening complication of an acute oropharyngeal infection. It is generally characterised by pharyngitis secondary to Fusobacterium necrophorum, causing thrombophlebitis of the internal jugular vein and sepsis, with subsequent formation of septic emboli that can rapidly spread to different organ sites. The condition is associated with high mortality if treatment with antibiotics is delayed, and recent evidence suggests that patients are at significant risk of in-hospital morbidity and long-term neurological sequelae. Although it is agreed that antibiotics are the mainstay of treatment, there is currently no consensus on the use of anticoagulation in the condition. This review article aims to summarise our current understanding of Lemierre\'s syndrome with regard to its definition, epidemiology, microbiology, presentation, diagnosis, and treatment.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    Lemierre综合征(LS)是一种罕见的疾病实体,这可能是灾难性的,如果生物体为导向的治疗不及早开始。Lemierre综合征通常是由梭菌感染引起的,梭菌感染通常对克林霉素敏感。有证据表明,耐药梭杆菌属的发病率有所增加。通过这个案例,我们提出了一个独特的案例,即一名45岁的白人女性患有Lemierre综合征,这是由于对克林霉素具有抗性的多微生物生物,因此尽管使用抗生素,但仍发生复发性感染。
    Lemierre\'s syndrome (LS) is a rare disease entity, which can be catastrophic if organism-directed treatment is not initiated early. Lemierre\'s syndrome is frequently caused by Fusobacterium infection which is frequently susceptible to clindamycin. Evidence suggests there is an increase in the incidence of cases of drug resistant Fusobacterium species. Through this case we present a unique case of a 45-year-old Caucasian female with Lemierre\'s Syndrome due to polymicrobial organisms that were resistant to clindamycin thus developing recurrent infections despite being on antibiotics.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    尽管坏死梭杆菌被很好地描述为幼儿急性乳突炎的新兴病原体,其他厌氧菌感染可导致类似的严重后遗症,包括颅内和颅外化脓性血栓性静脉炎和败血症。我们描述了一名患者,该患者在从手术标本中获得16S下一代测序结果后,其无明显暴露史的意义增加。本文综述了新型病原体化脓性拟杆菌。
    Although Fusobacterium necrophorum is well described as an emerging pathogen of acute mastoiditis in young children, infection with other anaerobes can lead to similar severe sequelae including intracranial and extracranial suppurative thrombophlebitis and sepsis. We describe a patient whose unremarkable exposure history assumed increased significance upon obtaining the results of 16S next generation sequencing from a surgical specimen. The novel pathogen Bacteroides pyogenes is reviewed herein.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    我们报告了一例17岁的女性,该女性患有严重的鼻旁鼻窦炎继发的眼眶蜂窝织炎和脑膜受累,血液培养阳性坏死梭杆菌。患者经过2个月的全身性抗生素和功能性内窥镜鼻窦手术后康复。坏死梭杆菌诱导的眼眶蜂窝织炎是一种罕见的实体,文献中只有5例以前的病例报道,这些也在这里回顾。这篇综述表明,坏死梭杆菌是眼眶蜂窝织炎的侵袭性病原体,因此我们建议受影响的患者可能需要相应的积极医疗管理。此外,我们建议额外的检查以排除Lemierre综合征,坏死梭杆菌感染的严重并发症,包括经胸超声心动图,胸部X光片,上肢静脉双工和磁共振静脉造影。
    We report a case of a 17-year-old female who presented with orbital cellulitis and meningeal involvement secondary to severe paranasal sinusitis with positive blood culture for Fusobacterium necrophorum. The patient recovered after a 2-month course of systemic antibiotics and functional endoscopic sinus surgery.Fusobacterium necrophorum-induced orbital cellulitis is a rare entity, with only 5 previous cases reported in the literature, which are reviewed here as well. This review reveals that Fusobacterium necrophorum is an aggressive pathogen in orbital cellulitis and therefore we suggest that affected patients may require a correspondingly aggressive medical management. Furthermore, we advise additional workup to rule out Lemierre\'s syndrome, a severe complication of Fusobacterium necrophorum infection, including transthoracic echocardiogram, chest radiograph, upper extremities\' venous duplex and magnetic resonance venography.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    Lemierre综合征(LS)是一种罕见的临床实体,其特征是原发性口咽感染并随后发生化脓性血栓性静脉炎。根据颈内静脉(IJV)血栓形成的临床或影像学证据进行诊断。以及转移灶,如肺部或关节。很少报道在没有弥散性血管内凝血(DIC)的Lemierre综合征中危及生命的血小板减少症。我们介绍了一个41岁的妇女Lemierre综合征,由β-溶血性C组链球菌和梭菌菌种引起,表现为咽炎恶化,IJV血栓形成,并发严重的血小板减少症。
    Lemierre\'s syndrome (LS) is an uncommon clinical entity characterized by a primary oropharyngeal infection with subsequent septic thrombophlebitis. Diagnosis is made with clinical or radiographic evidence of internal jugular vein (IJV) thrombosis, along with metastatic focus such as lungs or joints. Life threatening thrombocytopenia in Lemierre\'s syndrome in the absence of disseminated intravascular coagulation (DIC) is rarely reported. We present a case of a 41-year-old woman with Lemierre\'s syndrome caused by beta-hemolytic group C streptococci and fusobacterium species manifested as worsening pharyngitis, IJV thrombosis, and complicated by severe thrombocytopenia.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    BACKGROUND: Lemierre\'s syndrome is a rare and potentially fatal entity characterized by the spread of an oropharyngeal infection, with secondary suppurative thrombophlebitis of the internal jugular vein and septic emboli.
    METHODS: We discuss the case of a 52-year-old male who developed Lemierre\'s syndrome following peritonsillar abscess. He presented with submandibular and submental swelling extending into the neck. His management included; incision and drainage of the abscesses; and prolonged anticoagulant therapy.
    CONCLUSIONS: The incidence of Lemierre\'s disease appears to be increasing, perhaps due to ignorance of the disease by many clinicians, and diagnosis is often delayed with potentially fatal consequences.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

  • 文章类型: Case Reports
    Introduction: Lemierre\'s syndrome is a septic thromboembolic complication of an oropharyngeal or neck infection, primarily caused by Fusobacterium species. Although it usually affects young healthy patients, some case reports describe this syndrome in older population.Methods: A case report and a systematic review of the literature were conducted to investigate the late onset of Lemierre\'s syndrome. Forty-one articles were selected for the qualitative analysis, 39 for the quantitative analysis.Results: The average age of the study population was 52 years old. Diabetes mellitus and upper gastro-intestinal malignancy, common comorbidities in the study population, might play a role in the development of late-onset Lemierre\'s syndrome. Empiric antibiotic treatment should cover Fusobacterium and Streptococcus species both, which may cooperate to induce purulent disease. Reported unfavourable outcome was more than expected.Conclusion: Lemierre\'s syndrome in adulthood may differ from the usual version. This disease may further pass unrecognized, if presented out of the expected age range. Nevertheless, early diagnosis and prompt treatment are a requisite to prevent morbidity and mortality, which may be higher in this older population.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

公众号