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勒米尔综合征(LS)合并第十二对脑神经麻痹

Lemierre's Syndrome (LS) Complicated by Cranial Nerve XII Palsy.

作者信息

Ojeniyi Solabomi O, Ibukun Francis, Kanemo Philip

机构信息

Internal Medicine, MedStar Union Memorial Hospital, Baltimore, USA.

Internal Medicine, Rapides Regional Medical Center, Alexandria, USA.

出版信息

Cureus. 2023 Apr 26;15(4):e38181. doi: 10.7759/cureus.38181. eCollection 2023 Apr.

Abstract

Lemierre's syndrome (LS) is a rare medical condition that involves an acute oropharyngeal infection leading to septic thrombophlebitis of the internal jugular vein with embolic spread to organs like the kidneys, lungs, and large joints. Only very little literature has reported central nervous system involvement with LS. This is a case of 34-year-old woman with right-sided neck pain, swallowing difficulties, and a sore throat of 3 days duration at the time of presentation. CT of the neck with contrast showed a ruptured right peritonsillar abscess and thrombus in the right internal jugular vein suspicious of thrombophlebitis. The patient was managed for LS with IV antibiotics and anticoagulation. However, her clinical course was complicated by cranial nerve XII palsy, which is an extremely rare manifestation of LS.

摘要

勒米尔综合征(LS)是一种罕见的医学病症,它涉及急性口咽感染,进而导致颈内静脉脓毒性血栓性静脉炎,并伴有栓子扩散至肾脏、肺和大关节等器官。仅有极少的文献报道过勒米尔综合征累及中枢神经系统的情况。这是一例34岁女性患者,就诊时右侧颈部疼痛、吞咽困难且咽痛已持续3天。颈部增强CT显示右侧扁桃体周围脓肿破裂,右侧颈内静脉有血栓,怀疑存在血栓性静脉炎。该患者接受了针对勒米尔综合征的静脉抗生素治疗及抗凝治疗。然而,她的临床病程因十二对脑神经麻痹而复杂化,这是勒米尔综合征极为罕见的一种表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/277c/10220427/7ef0d7d34ce8/cureus-0015-00000038181-i01.jpg

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