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[勒米尔综合征:一种复杂的口咽感染]

[The Lemierre syndrome: a complicated oropharyngeal infection].

作者信息

Libeer C, Bockaert J, Van den Brande P, Zachee P, Van de Vyvere M, Geyskens W

出版信息

Acta Clin Belg. 2005 Sep-Oct;60(4):173-9. doi: 10.1179/acb.2005.031.

Abstract

The Lemierre syndrome or 'necrobacillosis' is a post angina sepsis caused by an acute oropharyngeal infection with a secondary thrombophlebitis of the internal jugular vein. There are often septic emboli in the lungs, although intestinal organs can also be affected. This syndrome is caused by the strictly anaerobic gram-negative pathogen Fusobacterium necrophorum, sometimes in combination with other pathogens. The patient typically presents with high fever, pain in the neck, malaise and dyspnoea one week after the start of an angina. Plain chest radiograph shows bilateral nodular infiltrates, ultrasound reveals a thrombophlebitis of the internal jugular vein. CT scan can be useful to confirm the diagnosis and possible complications. In the beginning there is often a transient hyperbilirubinemia with toxic inflammatory blood results. Under the correct antibiotic regime complete recovery can be obtained.

摘要

勒米尔综合征或“坏死杆菌病”是一种由急性口咽感染伴颈内静脉继发性血栓性静脉炎引起的心绞痛后败血症。肺部常有脓毒性栓子,尽管肠道器官也可能受到影响。该综合征由严格厌氧的革兰氏阴性病原体坏死梭杆菌引起,有时与其他病原体联合感染。患者通常在心绞痛发作一周后出现高热、颈部疼痛、不适和呼吸困难。胸部X线平片显示双侧结节状浸润,超声显示颈内静脉血栓性静脉炎。CT扫描有助于确诊及发现可能的并发症。起初常有短暂的高胆红素血症及毒性炎症血液结果。在正确的抗生素治疗方案下可实现完全康复。

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