Akiyama Kosuke, Karaki Masayuki, Samukawa Yasushi, Mori Nozomu
Department of Otolaryngology, Faculty of Medicine, Kagawa University, Kita-gun Miki-cho Ikenobe 1750-1, Kagawa, Japan.
Auris Nasus Larynx. 2013 Oct;40(5):493-6. doi: 10.1016/j.anl.2012.09.006. Epub 2012 Oct 22.
A 65-year-old man presented with right facial cellulitis and right blindness. Enhanced CT and MRI showed right facial cellulitis involved with pterigopalatine fossa. Additionally, orbital cellulitis, superior ophthalmic vein thrombosis, and pulmonary multiple nodules were observed. (18)F-FDG PET/CT supported these findings. He was diagnosed with septic superior ophthalmic vein thrombosis accompanied with Lemierre Syndrome variant and was treated mainly by the administration of intravenous antibiotics. His symptoms and image findings improved after a few days of treatment, but the right visual loss has not recovered. Since septic superior ophthalmic vein thrombosis and Lemierre Syndrome both have life-threatening potential, early diagnosis and appropriate treatment are important and may contribute to reduce the incidence of severe complications. Septic superior ophthalmic vein thrombosis accompanied with Lemierre Syndrome is exceeding rare, and this case is the first report of blindness in Lemierre Syndrome. A literature review and discussion of septic superior ophthalmic vein thrombosis and Lemierre Syndrome are included.
一名65岁男性出现右侧面部蜂窝织炎和右眼失明。增强CT和MRI显示右侧面部蜂窝织炎累及翼腭窝。此外,还观察到眼眶蜂窝织炎、眼上静脉血栓形成和肺部多发结节。(18)F-FDG PET/CT支持这些发现。他被诊断为伴有勒米尔综合征变异型的感染性眼上静脉血栓形成,主要通过静脉注射抗生素进行治疗。治疗几天后,他的症状和影像学表现有所改善,但右眼视力丧失尚未恢复。由于感染性眼上静脉血栓形成和勒米尔综合征都有危及生命的可能性,早期诊断和适当治疗很重要,可能有助于降低严重并发症的发生率。伴有勒米尔综合征的感染性眼上静脉血栓形成极为罕见,该病例是勒米尔综合征导致失明的首例报告。本文还包括对感染性眼上静脉血栓形成和勒米尔综合征的文献综述及讨论。