Camacho-Cruz Jhon, Preciado Helen, Beltrán Natalia, Fierro Laura, Carrillo Jorge
School of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Hospital de San José, Bogotá, Colombia,
Department of Pediatrics, Hospital de San José, Bogotá, Colombia,
ORL J Otorhinolaryngol Relat Spec. 2019;81(4):234-239. doi: 10.1159/000500560. Epub 2019 Jul 17.
Lemierre's syndrome is an infrequent disease characterized by septic thrombosis of the internal jugular vein followed by pulmonary embolism generally occurring after upper respiratory and gastrointestinal tract infections. We present the case of a 15-year-old female patient with postseptal cellulitis and cervical abscess who developed pulmonary embolism and pleural effusion secondary to internal jugular vein thrombosis. Cultures were positive for Streptococcus anginosus, antibiotic treatment was established with satisfactory clinical outcome. High clinical suspicion is required for a diagnosis. The mainstay of treatment is a multidisciplinary approach based on two essential pillars: antibiotic therapy and surgical drainage. This is an important case because of the unusual presentation, the isolation of an infrequent pathogen, and the primary infection site (postseptal cellulitis), which are rare characteristics of this condition in the pediatric population.
勒米尔综合征是一种罕见疾病,其特征为颈内静脉脓毒性血栓形成,随后通常在上呼吸道和胃肠道感染后发生肺栓塞。我们报告一例15岁女性患者,患有鼻中隔后蜂窝织炎和颈部脓肿,继发颈内静脉血栓形成后出现肺栓塞和胸腔积液。培养结果显示咽峡炎链球菌呈阳性,采用抗生素治疗,临床结果令人满意。诊断需要高度的临床怀疑。治疗的主要方法是基于两个基本支柱的多学科方法:抗生素治疗和手术引流。这是一个重要病例,因为其表现不寻常、分离出罕见病原体以及原发性感染部位(鼻中隔后蜂窝织炎),这些都是该疾病在儿科人群中罕见的特征。