Lemierre’s Syndrome

Lemierre 综合征
  • 文章类型: Case Reports
    Lemierre综合征是咽炎的一种罕见且严重的并发症,估计全球每年发病率为100,000人中的1人。其特征是颈内静脉化脓性血栓性静脉炎伴转移性感染,通常在口咽感染后。据报道,罕见的Lemierre综合征病例是由牙源性感染引起的。
    一名33岁的男性因发烧和咽喉痛的症状来我院就诊16天。其他症状包括左颈部和肩部疼痛。此外,代谢综合征是根据腰围诊断的,糖尿病,和高脂血症。使用宏基因组下一代测序(mNGS)技术检测坏死梭杆菌。增强的计算机断层扫描(CT)扫描显示左近端颈静脉和头臂静脉血栓形成。基于这些观察,诊断为Lemierre综合征。病因是在发病前约2周,根管牙齿中的填充物丢失,没有血液或疼痛。患者在抗生素和血液净化治疗后恢复。
    应评估发烧患者的Lemierre综合征,喉咙痛,颈部疼痛。如果根管治疗的填充物丢失,尤其是那些患有代谢综合征的人,我们应该意识到这种疾病的可能性。此外,mNGS检测可作为发热不确定患者的重要辅助诊断工具.
    UNASSIGNED: Lemierre\'s syndrome is a rare and serious complication of pharyngitis with an estimated annual incidence of 1 in 100,000 people worldwide. It is characterized by septic thrombophlebitis of the internal jugular vein with metastatic infection, usually after oropharyngeal infection. Rare cases of Lemierre\'s syndrome have been reported to be caused by odontogenic infection.
    UNASSIGNED: A 33-year-old male visited our hospital with symptoms of fever and sore throat for 16 days. The other symptoms included pain in his left neck and shoulder. In addition, metabolic syndrome was diagnosed based on waist circumference, diabetes, and hyperlipidemia. Fusobacterium necrophorum bacteria was detected using the metagenomic next-generation sequencing (mNGS) technique. The enhanced computerized tomography (CT) scan showed thrombosis of the left proximal jugular vein and brachiocephalic vein. Based on these observations, Lemierre\'s syndrome was diagnosed. The etiology was that the fillings in the root canal tooth were lost with no blood or pain about 2 weeks before the onset. The patient recovered after treatment with antibiotics and blood purification.
    UNASSIGNED: Lemierre\'s syndrome should be evaluated for patients with fever, sore throat, and neck pain. If the loss of fillings from root canal therapy occurs, especially for those with metabolic syndrome, we should be aware of the possibility of this disease. Furthermore, the mNGS test can be used as a crucial supplementary diagnostic tool for patients with undetermined fever.
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  • 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.
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  • 文章类型: Journal Article
    背景:Lemierre综合征是一种严重的医疗状况,可由口咽感染引起,通常由坏死梭杆菌引起,导致败血症,颈内静脉血栓形成,和转移性脓毒性栓子.然而,关于这种由链球菌引起的综合征的文献有限,以前很少有病例报告有颈深间隙感染。我们介绍了第一例由心绞痛链球菌引起的Lemierre综合征伴颈部深部脓肿。
    方法:一名无明显病史的53岁男性患者,一个月前意外吞下鱼骨后出现右侧颈部疼痛。喉镜检查未显示任何异常。入院前五天,病人发高烧。影像学检查显示颈内静脉血栓形成和颈动脉鞘周围的颈部脓肿。血培养结果阳性为链球菌感染,患者被诊断为Lemierre综合征。患者接受了手术引流,并接受了抗生素和抗凝治疗,临床进展满意。他在住院16天后出院。
    结论:尽管Lemierre综合征很少见,它需要注意,因为它可能导致严重的并发症,需要及时治疗。颈部深部空间感染可能危及生命,医生必须意识到其潜在的严重程度。
    BACKGROUND: Lemierre\'s Syndrome is a severe medical condition that can result from oropharyngeal infection, typically caused by Fusobacterium necrophorum, leading to sepsis, internal jugular vein thrombosis, and metastatic septic emboli. However, there is limited literature on this syndrome caused by Streptococcus anginosus, and few previous cases have been reported to have deep neck space infection. We present the first case of Lemierre\'s Syndrome caused by Streptococcus anginosus with deep neck abscess.
    METHODS: A 53-year-old male patient with no significant medical history presented with right neck pain after accidentally swallowing a fish bone one month ago. Laryngoscopy did not reveal any abnormalities. Five days prior to admission, the patient developed high fever. Imaging studies showed internal jugular vein thrombosis and a neck abscess surrounding the carotid artery sheath. Blood culture results were positive for Streptococcus anginosus infection, and the patient was diagnosed with Lemierre\'s syndrome. The patient underwent surgical drainage and received antibiotics and anticoagulant therapy, and had satisfactory clinical progress. He was discharged after a 16-day hospitalization.
    CONCLUSIONS: Although Lemierre\'s syndrome is rare, it needs attention because it can lead to serious complications and requires timely treatment. Deep neck space infections can be life-threatening and doctors must be aware of its potential severity.
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