B K Anupama, Gilotra Tarvinder, Tymko Casey, Siddique Zaid, Eranki Ambika
Internal Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.
Infectious Disease, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.
Cureus. 2020 Apr 22;12(4):e7787. doi: 10.7759/cureus.7787.
Lemierre's syndrome is a rare but life-threatening condition characterized by an oropharyngeal infection typically secondary to Fusobacterium necrophorum resulting in septic thrombophlebitis of the internal jugular vein. Streptococcus intermedius is a particularly rare cause of Lemierre's syndrome with only a few cases reported in the literature. Here we describe a rare case of Lemierre's syndrome, caused by Streptococcus intermedius, likely secondary to an odontogenic infection, found to have a cervical epidural abscess with concomitant large retropharyngeal and prevertebral abscesses on presentation, in whom the clinical course was further complicated by an extensive cerebral venous sinus thrombosis. However, despite grave complications, early diagnosis and appropriate emergency management including intravenous antibiotics and surgical intervention led to a successful recovery, thus demonstrating that aggressive measures can potentially lead to a favorable outcome.
勒米尔综合征是一种罕见但危及生命的疾病,其特征为口咽感染,通常继发于坏死梭杆菌,导致颈内静脉脓毒性血栓性静脉炎。中间型链球菌是勒米尔综合征极为罕见的病因,文献中仅报道过少数病例。在此,我们描述一例罕见的由中间型链球菌引起的勒米尔综合征病例,可能继发于牙源性感染,就诊时发现伴有颈段硬膜外脓肿以及巨大的咽后和椎体前脓肿,其临床过程因广泛的脑静脉窦血栓形成而进一步复杂化。然而,尽管出现了严重并发症,但早期诊断及包括静脉使用抗生素和手术干预在内的适当紧急处理措施使患者成功康复,从而表明积极的治疗措施有可能带来良好的预后。