Sabaka Peter, Kachlíková Mária, Bendžala Matej, Káčerová Helena
Department of Infectology and Geographical Medicine, Faculty of Medicine, Comenius University in Bratislava, Limbova 5, 831 01, Slovak Republic.
IDCases. 2019 Nov 6;19:e00664. doi: 10.1016/j.idcr.2019.e00664. eCollection 2020.
is an extremely rare case of the Lemierre syndrome, which is characterized as septic thrombophlebitis of the jugular vein as a consequence of oropharyngeal infection. We present a unique case of Lemierre syndrome caused by complicated by epidural abscess. The patient presented with fever, severe nuchal pain and stiffness and mild sore throat and headache. Computed tomography revealed a neck abscess localized dorsally to a left mandibular ramus and continuing caudally along the sternocleidomastoid muscle, thrombosis of the left internal jugular vein and fluid collection in the epidural space. Viewed under magnetic resonance imagining, the effusion had the character of an epidural abscess. Cultivation of oropharyngeal swab and blood cultures revealed . The neck abscess was surgically drained, and the patient was treated with a combination of parenteral antimicrobials until complete clinical and radiologic remission. This case highlights the importance of also covering the gram-negative facultative anaerobic rod spectrum in the empiric antimicrobial treatment of Lemierre syndrome.
这是一例极为罕见的勒米尔综合征病例，其特征为因口咽感染导致的颈静脉化脓性血栓性静脉炎。我们呈现了一例由硬膜外脓肿并发引起的独特的勒米尔综合征病例。患者表现为发热、严重的颈部疼痛和僵硬、轻度咽痛和头痛。计算机断层扫描显示颈部脓肿位于左下颌支背侧，并沿胸锁乳突肌向尾侧延伸，左颈内静脉血栓形成以及硬膜外间隙积液。在磁共振成像下观察，积液具有硬膜外脓肿的特征。口咽拭子培养和血培养显示……颈部脓肿通过手术引流，患者接受了胃肠外抗菌药物联合治疗，直至临床和影像学完全缓解。该病例强调了在勒米尔综合征的经验性抗菌治疗中覆盖革兰氏阴性兼性厌氧杆菌谱的重要性。
