Stauffer Craig, Josiah Anne F, Fortes Manuel, Menaker Jay, Cole John W
Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
J Emerg Med. 2013 Feb;44(2):e177-82. doi: 10.1016/j.jemermed.2012.02.075. Epub 2012 Sep 16.
Lemierre Syndrome (LS) is a highly aggressive rare disease process with a predilection for young, healthy adolescents. Often beginning with a primary cervicofacial infection, LS rapidly progresses to thrombophlebitis of the cerebral vasculature, metastatic infection, and septicemia. Untreated LS can be rapidly fatal. Thrombus within the cerebral vasculature can have devastating neurological effects. Advances in antibacterial therapy have resulted in a global decline in the incidence of LS, and clinicians may not consider LS early in the disease process. Although the mortality of LS has declined, the morbidity associated with the disease has increased, particularly the neurological sequelae.
This report will provide readers with a better understanding of the etiology, clinical presentation, evaluation methods, and appropriate treatment of LS.
We present an atypical case of LS secondary to community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection progressing to bilateral cavernous sinus and ophthalmic vein thromboses with resultant binocular vision loss secondary to optic nerve and retinal ischemia.
This case highlights the importance of early recognition of LS in the setting of a community-acquired MRSA infection as the unifying condition in a young patient with multiple acute neurologic impairments.
勒米尔综合征（LS）是一种侵袭性很强的罕见疾病，好发于年轻健康的青少年。LS通常始于原发性颈面部感染，迅速发展为脑血管系统的血栓性静脉炎、转移性感染和败血症。未经治疗的LS可能迅速致命。脑血管内的血栓可产生毁灭性的神经影响。抗菌治疗的进展导致全球范围内LS发病率下降，临床医生在疾病早期可能不会考虑到LS。尽管LS的死亡率有所下降，但与该疾病相关的发病率却有所增加，尤其是神经后遗症。
本报告将使读者更好地了解LS的病因、临床表现、评估方法和适当治疗。
我们报告一例非典型的LS病例，该病例继发于社区获得性耐甲氧西林金黄色葡萄球菌（MRSA）感染，进展为双侧海绵窦和眼静脉血栓形成，导致视神经和视网膜缺血继发双眼视力丧失。
本病例突出了在社区获得性MRSA感染背景下早期识别LS的重要性，这是一名患有多种急性神经功能障碍的年轻患者的统一病症。
