Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Braz J Infect Dis. 2013 Jul-Aug;17(4):507-9. doi: 10.1016/j.bjid.2012.11.010. Epub 2013 Jun 21.
Lemierre syndrome is characterized by acute septic thrombophlebitis of the internal jugular vein (IJV) that develops after an oropharyngeal infection, and can be complicated by septic emboli to lungs and other organs. The most frequent causative agent is Fusobacterium necrophorum, an anaerobic bacillus found in normal oropharyngeal flora. Staphylococcus aureus has emerged as a cause of Lemierre syndrome in the last decade. We report a case of a 24-year-old man who developed septic IJV thrombosis and necrotizing pneumonia due to S. aureus from an infected hematoma in the right sternocleidomastoid muscle. Antibiotics are the mainstay of therapy with few cases needing anticoagulation. A good outcome is dependent upon an awareness of the condition, a high index of suspicion, and prompt initiation of antibiotic therapy. Recognition of S. aureus as a cause of Lemierre syndrome can guide the choice of initial antibiotics to cover this virulent pathogen.
利氏综合征的特征是咽后感染后继发的颈内静脉（IJV）急性化脓性血栓性静脉炎，并可能伴有肺部和其他器官的化脓性栓塞。最常见的病原体是坏死梭杆菌，这是一种存在于正常咽腔菌群中的厌氧菌。金黄色葡萄球菌在过去十年中已成为利氏综合征的一个病因。我们报告了一例 24 岁男性的病例，其因右侧胸锁乳突肌血肿感染导致金黄色葡萄球菌感染，引发化脓性 IJV 血栓形成和坏死性肺炎。抗生素是治疗的主要方法，少数情况下需要抗凝治疗。良好的预后取决于对该疾病的认识、高度怀疑和及时开始抗生素治疗。认识到金黄色葡萄球菌是利氏综合征的病因可以指导初始抗生素的选择，以覆盖这种毒力强的病原体。
