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类钩端螺旋体病的勒米尔综合征

Lemierre's syndrome mimicking leptospirosis.

作者信息

Lin Dagmar, Suwantarat Nuntra, Young Royden S

机构信息

Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i 96813, USA.

出版信息

Hawaii Med J. 2010 Jul;69(7):161-3.

Abstract

Lemierre's syndrome is a suppurative thrombophlebitis involving the internal jugular vein, most commonly associated with Fusobacterium necrophorum, usually a complication of oropharyngeal infections. This syndrome is rare and is often overlooked. We present a case of sepsis mimicking initially severe leptospirosis (Weil's disease) due to acute febrile illness with multiorgan failure and hyperbilirubinemia. Finally, blood cultures revealed Fusobacterium necrophorum and computed tomography (CT) demonstrated bilateral pulmonary nodules and a thrombus in the right internal jugular vein. Early clinical suspicion is crucial so that appropriate diagnostic investigation and antibiotic therapy can be initiated to minimize the risk of life-threatening complications.

摘要

勒米尔综合征是一种累及颈内静脉的化脓性血栓性静脉炎,最常与坏死梭杆菌相关,通常是口咽感染的并发症。该综合征较为罕见,常被忽视。我们报告一例最初表现为酷似重症钩端螺旋体病(韦尔病)的脓毒症病例,该患者因急性发热性疾病出现多器官功能衰竭和高胆红素血症。最终,血培养发现坏死梭杆菌,计算机断层扫描(CT)显示双侧肺结节及右侧颈内静脉血栓形成。早期临床怀疑至关重要,以便能够启动适当的诊断性检查和抗生素治疗,将危及生命的并发症风险降至最低。

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本文引用的文献

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