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一名儿童患勒米尔综合征。

Lemierre's syndrome in a child.

作者信息

Hemani Fatima, Naveed Anjum, Akhtar Shakil, Shahid Saba

机构信息

Dr. Fatima Hemani, MBBS. Resident, Department of Pediatrics, Indus Hospital & Health Network, Karachi, Pakistan.

Dr. Anjum Naveed, FRCS. Senior Consultant, Department of ENT, Indus Hospital & Health Network, Karachi, Pakistan.

出版信息

Pak J Med Sci. 2022 Jan;38(2):433-435. doi: 10.12669/pjms.38.ICON-2022.5773.

Abstract

Lemierre's Syndrome (LS) is a rare syndrome most frequently due to an anaerobic organism, Fusobacterium Necrophorum. It is commonly a complication of an acute oropharyngeal infection, but there are exceptions to its presentations. In our case the cause of LS was otitis media caused by Streptococcus species. This is a rather unusual presentation of LS. LS is caused due to septic complications of oropharyngeal infections, which lead to thrombophlebitis of internal jugular vein leading to thrombosis formation. In this case report, we present a case of Lemierre's syndrome in a seven-year-old male child. The patient presented with high grade fever spikes and earache, which were unresponsive to oral antibiotics. LS was diagnosed in this patient on the basis of clinical, microbiological and radiological findings. After the diagnosis, treatment involved using broad spectrum antibiotics and anticoagulants, followed by surgery. Though role of anticoagulants is controversial in LS, but there is no specific guideline contraindicating the use of anti-coagulants. In our case, timely diagnosis and management enabled us to discharge the patient without any symptoms.

摘要

勒米尔综合征(LS)是一种罕见综合征,最常见病因是一种厌氧菌——坏死梭杆菌。它通常是急性口咽感染的并发症,但临床表现也有例外情况。在我们的病例中,勒米尔综合征的病因是链球菌引起的中耳炎。这是勒米尔综合征一种相当不寻常的表现。勒米尔综合征是由口咽感染的败血症并发症引起的,这些并发症会导致颈内静脉血栓性静脉炎,进而形成血栓。在本病例报告中,我们呈现了一名7岁男童患勒米尔综合征的病例。该患者出现高热峰值和耳痛,口服抗生素治疗无效。根据临床、微生物学和影像学检查结果,该患者被诊断为勒米尔综合征。诊断后,治疗包括使用广谱抗生素和抗凝剂,随后进行手术。尽管抗凝剂在勒米尔综合征中的作用存在争议,但没有具体指南禁止使用抗凝剂。在我们的病例中,及时的诊断和治疗使患者得以无症状出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78fb/8899900/f399cc81c091/PJMS-38-433-g001.jpg

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