Hedenmark Jan, Holm Karin, Moberger Fredrik, Torell Erik
VO Anestesi, Div Operation, Hudiksvalls sjukhus, 824 81 Hudiksvall - Hudiksvall, Sweden - VO Anestesi Hudiksvall, Sweden.
VO Infektionssjukdomar, Skånes Universitetssjukhus, Lund - Lund, Sweden VO Infektionssjukdomar, Skånes Universitetssjukhus, Lund - Lund, Sweden.
Lakartidningen. 2018 Feb 2;115:EWPE.
The purpose of this case report and discussion is to heighten the awareness of Lemierres syndrome (postanginal sepsis). Affected patients present in various fields of medicine and an increased incidence of "the forgotten disease" may be expected. Fusobacterium necrophorum is the most common pathogen. The clinical course includes a primary head or neck infection with thrombosis of the internal jugular vein with subsequent septic pulmonary embolization. The syndrome bears considerable morbidity and even mortality. People aged 15-25 years are commonly affected. Early diagnosis through positive blood culture and confirmation of jugular vein thrombosis combined with prompt antibiotic treatment and source control is mandatory in the management of Lemierre's syndrome. Assessment of vital organ function is recommended across the continuum of care as this facilitates recognition and initiation of therapeutic measures to counteract a complicated clinical course.
本病例报告及讨论的目的是提高对勒米埃综合征(咽后败血症)的认识。受影响的患者出现在医学的各个领域,预计这种“被遗忘的疾病”发病率会增加。坏死梭杆菌是最常见的病原体。临床过程包括原发性头颈部感染伴颈内静脉血栓形成,随后发生脓毒性肺栓塞。该综合征具有相当高的发病率甚至死亡率。15至25岁的人群通常易受影响。在勒米埃综合征的管理中,通过阳性血培养进行早期诊断并确认颈静脉血栓形成,同时迅速进行抗生素治疗和源头控制是必不可少的。建议在整个护理过程中评估重要器官功能,因为这有助于识别并启动治疗措施以应对复杂的临床过程。