Wong Andrew P, Duggins Maurice L, Neil Tara
From the Via Christi Family Medicine Residency, Wichita Center for Graduate Medical Education (APW) and the Via Christi Family Medicine Program (MLD, TN), Kansas University School of Medicine, Wichita.
J Am Board Fam Med. 2015 May-Jun;28(3):425-30. doi: 10.3122/jabfm.2015.03.140131.
Sore throat is a common presenting complaint in the outpatient setting. Most cases are nonbacterial in origin, but those that are bacterial are usually the result of group A β-hemolytic streptococcus. Guidelines exist to help physicians decide whether to treat with an antibiotic. Lemierre syndrome is a dangerous potential sequela of pharyngitis that results in septic thrombophlebitis of the internal jugular (IJ) vein. A high index of suspicion is needed to consider this diagnosis in the workup of pharyngitis and should be aggressively treated once identified. Consideration should be given to completing blood cultures and neck imaging because of clinical suspicion. The case study discussed here illustrates the presentation, evaluation, and treatment of Lemierre syndrome.
喉咙痛是门诊常见的就诊主诉。大多数病例并非由细菌引起，但细菌性病例通常是由A组β溶血性链球菌导致的。现有指南可帮助医生决定是否使用抗生素进行治疗。勒米尔综合征是咽炎的一种危险潜在后遗症，可导致颈内静脉的化脓性血栓性静脉炎。在咽炎的检查过程中，需要高度怀疑才能考虑这一诊断，一旦确诊应积极治疗。由于临床怀疑，应考虑进行血培养和颈部影像学检查。本文讨论的病例研究阐述了勒米尔综合征的临床表现、评估和治疗。
