Georgopoulos S, Korres S, Riga M, Balatsouras D, Kotsis G, Ferekidis E
ENT Department, Elpis General Hospital, Athens, Greece.
J Laryngol Otol. 2008 May;122(5):527-30. doi: 10.1017/S0022215107007256. Epub 2007 May 15.
Acute tonsillitis or pharyngitis may lead to suppurative thrombophlebitis of the internal jugular vein. This complication, also known as Lemierre's syndrome, remains, even nowadays, life threatening, due to dissemination of septic thromboemboli to various organs. Respiratory deficiency and renal impairment are often reported in patients suffering from Lemierre's syndrome.
The unusual clinical manifestation of this case involves severe acute renal and respiratory deficiency in addition to microangiopathic consumption coagulopathy in a young patient treated with macrolides five days after the onset of acute tonsillitis.
The usual causative pathogen, namely Fusobacterium necrophorum, shows a varying sensitivity to macrolides. As a result, the syndrome may present itself in a variety of clinical forms even in patients under treatment with macrolides. A high index of suspicion is therefore crucial for in time prevention of potentially life threatening complications.
急性扁桃体炎或咽炎可能导致颈内静脉化脓性血栓性静脉炎。这种并发症,也称为勒米尔综合征,即使在当今,由于感染性血栓栓子扩散到各个器官,仍然危及生命。呼吸功能不全和肾功能损害在勒米尔综合征患者中经常有报道。
该病例不同寻常的临床表现包括一名年轻患者在急性扁桃体炎发病五天后接受大环内酯类药物治疗时,除微血管病性消耗性凝血病外,还出现严重的急性肾和呼吸功能不全。
常见的致病病原体,即坏死梭杆菌,对大环内酯类药物的敏感性各不相同。因此,即使在接受大环内酯类药物治疗的患者中,该综合征也可能以多种临床形式出现。因此,高度的怀疑指数对于及时预防潜在的危及生命的并发症至关重要。