Min Seung Kee, Park Yeon Ho, Cho Yong Kyun, Park Jeong Woong, Koh Young Hwan, Seo Tae-Seok
Department of Surgery, Gachon Medical School Gil Medical Center, Incheon, South Korea.
Angiology. 2005 Jul-Aug;56(4):483-7. doi: 10.1177/000331970505600417.
Lemierre's syndrome is an uncommon septic thrombophlebitis of the internal jugular vein. The authors present the case of a 52-year-old woman with literature review. She developed flu-like symptoms and fever, and then painful swelling of the left side of her neck and left arm. Contrast-enhanced computed tomography of the neck revealed thrombosis in the left internal jugular vein, subclavian vein, and brachiocephalic vein and diffuse soft tissue inflammation around the veins. No microorganism was identified in the blood and venous thrombus, which was obtained by percutaneous aspiration thrombectomy. Systemic antibiotics and anticoagulation therapy achieved complete resolution of the symptoms. Recanalization of the thrombosed veins with no residual thrombi was observed on duplex scanning after 3 months. No pulmonary embolism or other metastatic infection was observed. Clinical suspicion seems to be essential to make an accurate diagnosis during the early stage of the disease, which is critical to obtain a successful outcome for Lemierre's syndrome.
勒米尔综合征是一种罕见的颈内静脉化脓性血栓性静脉炎。作者结合文献回顾介绍了一名52岁女性的病例。她出现了类似流感的症状和发热,随后左侧颈部和左臂出现疼痛性肿胀。颈部增强计算机断层扫描显示左颈内静脉、锁骨下静脉和头臂静脉血栓形成,静脉周围弥漫性软组织炎症。经皮抽吸血栓切除术获取的血液和静脉血栓中未发现微生物。全身抗生素和抗凝治疗使症状完全缓解。3个月后经双功扫描观察到血栓形成的静脉再通,无残留血栓。未观察到肺栓塞或其他转移性感染。在疾病早期,临床怀疑对于准确诊断似乎至关重要,这对于勒米尔综合征获得成功治疗结果至关重要。