Bentley Thomas P, Brennan Daniel F
Department of Emergency Medicine, Emergency Medicine Residency Program, Orlando Regional Medical Center, Orlando, Florida 32806-2093, USA.
J Emerg Med. 2009 Aug;37(2):131-4. doi: 10.1016/j.jemermed.2007.07.066. Epub 2008 Feb 14.
Lemierre's syndrome is septic thrombophlebitis of the internal jugular vein, arising as a complication of an oropharyngeal infection. This thrombophlebitis frequently results in septic emboli to organs such as the lungs. The causative agent in most previously described cases is Fusobacterium necrophorum, an anaerobic Gram-negative organism. We present the case of an 8-year-old previously healthy girl who came to the Emergency Department with a 5-day history of left-sided neck pain and was subsequently diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) Lemierre's syndrome. MRSA has not previously been described in Lemierre's syndrome in the Emergency Medicine literature. The clinical presentation, findings, and management of the syndrome are discussed. Regardless of etiology, once the diagnosis of Lemierre's syndrome is made, long-term broad-spectrum intravenous therapy will be necessary.
勒米尔综合征是颈内静脉的化脓性血栓性静脉炎,是口咽感染的一种并发症。这种血栓性静脉炎常导致肺部等器官出现脓毒性栓子。在大多数先前描述的病例中,病原体是坏死梭杆菌,一种厌氧革兰氏阴性菌。我们报告一例8岁以前健康的女孩,她因左侧颈部疼痛5天前来急诊科,随后被诊断为耐甲氧西林金黄色葡萄球菌(MRSA)勒米尔综合征。急诊医学文献中此前尚未有关于MRSA导致勒米尔综合征的描述。本文讨论了该综合征的临床表现、检查结果及治疗方法。无论病因如何,一旦诊断为勒米尔综合征,长期广谱静脉治疗将是必要的。