Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA.
J Craniofac Surg. 2021 May 1;32(3):1079-1082. doi: 10.1097/SCS.0000000000007363.
Lemierre syndrome (LS) is a rare, but serious condition most commonly associated with oropharyngeal bacterial infection. Infection results in thrombophlebitis of the internal jugular vein and its tributaries. It usually affects previously healthy young adults. The authors report an unusual case of an elderly patient with penicillin allergy who developed Lemierre syndrome from an odontogenic infection (Streptococcus intermedius) resistant to clindamycin. She developed thrombosis of the internal jugular vein and superior ophthalmic vein resulting in visual changes. Treatment required incision and drainage, intravenous antibiotics and anticoagulation. Antibiotics were tailored to culture and sensitivities after testing response to a beta-lactam. With antibiotic resistance increasing, investigation of penicillin allergies is warranted for severe head and neck infections.
利氏综合征（Lemierre syndrome，LS）是一种罕见但严重的疾病，通常与咽腔细菌感染有关。感染导致颈内静脉及其属支的血栓性静脉炎。它通常影响以前健康的年轻成年人。作者报告了一例不常见的老年青霉素过敏患者，该患者因对克林霉素耐药的牙源性感染（中间链球菌）而发生利氏综合征。她发生颈内静脉和眼上静脉血栓形成，导致视力改变。治疗需要切开引流、静脉内抗生素和抗凝治疗。抗生素根据对β-内酰胺类药物反应的测试结果进行调整。随着抗生素耐药性的增加，对于严重的头颈部感染，有必要对青霉素过敏进行调查。
