Stubington Thomas James, James Paul
ENT, Queen's Medical Centre Nottingham, Nottingham, UK.
Critical Care, Queen's Medical Centre Nottingham, Nottingham, UK.
BMJ Case Rep. 2018 Jan 3;2018:bcr-2017-222723. doi: 10.1136/bcr-2017-222723.
Lemierre's syndrome is a potentially life-threatening consequence of oropharyngeal and ear infections and often results in critical care admission and even intubation. Due to the multisystem manifestation, multiple teams may initially be involved in the care, some of which may be unfamiliar with the features and usual clinical course. This report describes a case in a 36-year-old woman with the classic features of internal jugular vein thrombosis and septic emboli to the lungs secondary to an oropharyngeal infection. Treatment comprised antibiotic therapy, anticoagulation and fluid resuscitation, and was carried out in a high dependency unit setting. At follow-up 3 months after discharge, the patient was well with no residual symptoms off all treatment. During the events of this case, it became apparent that while ear, nose and throat and infectious diseases team members were relatively familiar with the condition, other departments including the critical care team were less so.
勒米尔综合征是口咽和耳部感染可能危及生命的后果，常导致重症监护病房收治，甚至需要插管。由于其多系统表现，最初可能有多个团队参与治疗，其中一些团队可能不熟悉其特征和常见临床病程。本报告描述了一名36岁女性的病例，该患者具有颈内静脉血栓形成和口咽感染继发肺部脓毒性栓子的典型特征。治疗包括抗生素治疗、抗凝和液体复苏，在高依赖病房进行。出院后3个月随访时，患者情况良好，停用所有治疗后无残留症状。在该病例过程中，很明显，虽然耳鼻喉科和传染病科团队成员对该疾病相对熟悉，但包括重症监护团队在内的其他科室则不然。
