Boldt Brian M, Nguyen David, Faga Melissa, Caras William
Department of Radiology, Madigan Army Medical Center, Tacoma, Washington, USA.
BMJ Case Rep. 2010 Nov 19;2010:bcr0620103121. doi: 10.1136/bcr.06.2010.3121.
We report a case of a previously healthy 33-year-old male who presented to his primary care physician with nausea, vomiting, diarrhoea and fever. One week prior to presentation the patient reported a history of sore throat which he presumed to be a viral infection and sought no medical attention. Upon hospital presentation, the patient was admitted and rapidly progressed to sepsis and respiratory failure. Goal directed therapy was initiated and the patient was intubated. Further clinical work up included blood cultures revealing Fusobacterium varium bacteraemia, and CT and ultrasound imaging demonstrated thrombosis of the internal jugular vein and septic pulmonary emboli. A diagnosis of Lemierre syndrome was made, and antibiotics as well as anticoagulation therapy were initiated. The patient's clinical condition improved with treatment, and he was discharged home on hospital day 12 with completion of an uneventful 4-week course of outpatient antibiotic and anticoagulation therapy.
我们报告一例病例，患者为一名33岁的既往健康男性，因恶心、呕吐、腹泻和发热就诊于其初级保健医生处。就诊前一周，患者报告有咽痛病史，他认为是病毒感染，未寻求医疗救治。入院后，患者被收治并迅速发展为脓毒症和呼吸衰竭。启动了目标导向治疗，患者接受了插管。进一步的临床检查包括血培养发现具核梭杆菌菌血症，CT和超声成像显示颈内静脉血栓形成和脓毒性肺栓塞。诊断为勒米尔综合征，开始使用抗生素及抗凝治疗。经治疗，患者的临床状况有所改善，在住院第12天出院，完成了为期4周的门诊抗生素和抗凝治疗，过程顺利。
