General Surgery, University Hospital Aintree, Lower Lane, Liverpool L97AL, UK.
Infectious Diseases, Royal Liverpool Hospital, Prescot Street, Liverpool L7 8XP, UK.
World J Emerg Surg. 2014 May 15;9:38. doi: 10.1186/1749-7922-9-38. eCollection 2014.
Lemierre's disease is characterized by sepsis, often with an oropharyngeal source, secondary septic emboli and internal jugular vein thrombosis (Lancet 1:701-3, 1936. Clin Microbiol Rev 20(4):622-59, 2007). Septic emboli affecting many bodily sites have been reported, including the lungs, joints, bones, and brain. The case report describes an unusual case of Lemierre's disease in a 64 year old gentleman causing profound sepsis, acute kidney injury, bilateral iliopsoas abscesses and a right hand abscess. To our knowledge, this is the first reported case of Lemierre's disease in the context of bilateral psoas abscesses, and highlights the ambiguity surrounding the definition of Lemierre's disease. The clinical literature review highlights the difficulty in definitively diagnosing the condition and offers some suggestions for recognising and refining the diagnostic criterion of Lemierre's.
李司忒菌病的特征为脓毒血症,常源自口咽部,继发脓毒栓子和颈内静脉血栓(1936 年《柳叶刀》第 1 卷第 701-703 页;2007 年《临床微生物学评论》第 20 卷第 622-659 页)。已有报道称脓毒栓子可影响身体多个部位,包括肺部、关节、骨骼和大脑。本病例报告描述了一例罕见的李司忒菌病,发生于 64 岁男性,导致严重脓毒血症、急性肾损伤、双侧腰大肌脓肿和右手脓肿。据我们所知,这是首例报道的李司忒菌病合并双侧腰大肌脓肿病例,突显了李司忒菌病定义的模糊性。临床文献复习强调了明确诊断该病的困难,并为识别和完善李司忒菌病的诊断标准提供了一些建议。