Kizhner V, Samara G, Panesar R, Krespi Y P
Department of Otolaryngology, St. Luke's-Roosevelt Hospital, New York, New York, USA.
J Laryngol Otol. 2013 Jul;127(7):721-3. doi: 10.1017/S0022215113001035. Epub 2013 May 24.
Community-acquired methicillin-resistant Staphylococcus aureus is a growing health concern. Lemierre's syndrome is a septic jugular thrombophlebitis that primarily affects young adults. This paper aimed to identify a possible sub-group of Lemierre's syndrome cases associated with community-acquired methicillin-resistant Staphylococcus aureus.
This paper reports the case of a 16-year-old male who was admitted for increasing fever, tachycardia, tachypnoea and neck pain. The patient was diagnosed with methicillin-resistant Staphylococcus aureus bacteraemia associated with Lemierre's syndrome. A literature review was subsequently conducted.
Following intravenous antibiotic treatment and the sterilisation of blood cultures, the patient improved. The literature review indicated a rise in the past 2 years of Lemierre's syndrome associated with methicillin-resistant Staphylococcus aureus among patients less than 18 years of age.
Community-acquired methicillin-resistant Staphylococcus aureus bacteraemia can lead to pulmonary sequelae. When it is associated with pharyngitis, nasopharyngitis or parapharyngeal lymphadenitis, the affected patient may be predisposed to Lemierre's syndrome. As bacterial carriage is predominantly nasal, pharyngitis may not be present. Methicillin-resistant Staphylococcus aureus should be included as an offending bacterium where there is suspicion of Lemierre's syndrome. It is unclear whether anticoagulation alters the course of the bacterium, and surgery is probably contraindicated.
社区获得性耐甲氧西林金黄色葡萄球菌对健康的影响日益受到关注。勒米尔综合征是一种主要影响年轻人的化脓性颈静脉血栓性静脉炎。本文旨在确定与社区获得性耐甲氧西林金黄色葡萄球菌相关的勒米尔综合征病例的一个可能亚组。
本文报告了一名16岁男性患者的病例，该患者因发热、心动过速、呼吸急促和颈部疼痛加剧入院。患者被诊断为与勒米尔综合征相关的耐甲氧西林金黄色葡萄球菌菌血症。随后进行了文献综述。
经过静脉抗生素治疗和血培养灭菌后，患者病情好转。文献综述表明，在过去2年中，18岁以下患者中与耐甲氧西林金黄色葡萄球菌相关的勒米尔综合征有所增加。
社区获得性耐甲氧西林金黄色葡萄球菌菌血症可导致肺部后遗症。当它与咽炎、鼻咽炎或咽旁淋巴结炎相关时，受影响的患者可能易患勒米尔综合征。由于细菌携带主要在鼻腔，可能不存在咽炎。在怀疑有勒米尔综合征的情况下，应将耐甲氧西林金黄色葡萄球菌列为致病细菌。目前尚不清楚抗凝是否会改变细菌的病程，手术可能是禁忌的。
