[一例以颈深部坏死性蜂窝织炎为表现的勒米尔综合征]
[A cervical necrotizing cellulitis revealing a Lemierre syndrome].
作者信息
Assouan C, Salami A, Anzouan-Kacou E, Nguessan N, Konan E
机构信息
Service de stomatologie et chirurgie maxillo-faciale, CHU de Treichville, Abidjan, Côte d'Ivoire.
Service de stomatologie et chirurgie maxillo-faciale, CHU de Treichville, Abidjan, Côte d'Ivoire.
出版信息
Rev Stomatol Chir Maxillofac Chir Orale. 2016 Jun;117(3):158-60. doi: 10.1016/j.revsto.2016.01.001. Epub 2016 Mar 7.
INTRODUCTION
Lemierre syndrome is characterized by a septic thrombophlebitis of the internal jugular vein (IJV) following an oropharyngeal infection.
CASE REPORT
We report a case of Lemierre syndrome that occurred in a context of angina and necrotizing cellulitis of the neck in a 45-year-old patient. The Doppler ultrasound exam of the neck vessels and a neck CT showed an IJV thrombophlebitis. No germ could be isolated in the samples (blood culture, pus). The treatment associated antibiotics, heparin and surgical debridement of the necrotic tissues with extraction of the thrombus after ligation and section of the IJV. The postoperative course was uneventful.
DISCUSSION
Lemierre syndrome is a rare but serious disease. Its low incidence makes him a forgotten disease. It should be systematically suspected in any oropharyngeal infection with the presence of a large painful swelling of the neck.
引言
勒米尔综合征的特征是口咽感染后颈内静脉发生脓毒性血栓性静脉炎。
病例报告
我们报告一例45岁患者在心绞痛和颈部坏死性蜂窝织炎背景下发生的勒米尔综合征。颈部血管多普勒超声检查和颈部CT显示颈内静脉血栓性静脉炎。样本（血培养、脓液）中未分离出细菌。治疗采用抗生素、肝素，并对坏死组织进行手术清创，在结扎和切断颈内静脉后取出血栓。术后过程顺利。
讨论
勒米尔综合征是一种罕见但严重的疾病。其低发病率使其成为一种被遗忘的疾病。在任何伴有颈部巨大疼痛性肿胀的口咽感染中都应系统性地怀疑该病。
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