Mobarakai Olivia, Barrios Sofia, Singh Ajit, Stone Jarle
Pennsylvania Hospital of the University of Pennsylvania Health System, United States.
IDCases. 2024 Jun 27;37:e02014. doi: 10.1016/j.idcr.2024.e02014. eCollection 2024.
Lemierre's syndrome, or postanginal sepsis, is an uncommon but potentially fatal infection of the internal jugular vein. The combination of bacteremia, internal jugular vein thrombophlebitis, and metastatic septic emboli secondary to acute pharyngeal infections is characteristic of Lemierre's syndrome. Isolated pathogens are typically oral anaerobic bacteria, most commonly Fusobacterium necrophorum. While the incidence of Lemierre's syndrome has declined over the years, the proportion of cases caused by uncommonly implicated bacteria have been increasingly cited in the literature (1). In this case report, we introduce a novel presentation of Lemierre's syndrome in a patient who presented to the emergency department with neck swelling and shortness of breath and was found to have infectious myositis and bacteremia with methicillin-resistant . Clinicians should be vigilant of underlying thrombus in patients with neck swelling and infectious myositis as our patient's internal jugular vein thrombus was missed on initial computed tomography read.
勒米尔综合征,即咽后败血症,是一种罕见但可能致命的颈内静脉感染。菌血症、颈内静脉血栓性静脉炎以及继发于急性咽部感染的转移性脓毒性栓子同时出现是勒米尔综合征的特征。分离出的病原体通常是口腔厌氧菌,最常见的是坏死梭杆菌。虽然多年来勒米尔综合征的发病率有所下降,但文献中越来越多地提到由罕见细菌引起的病例比例(1)。在本病例报告中,我们介绍了一例勒米尔综合征的新表现,该患者因颈部肿胀和呼吸急促就诊于急诊科,被发现患有感染性肌炎和耐甲氧西林菌血症。临床医生应对颈部肿胀和感染性肌炎患者的潜在血栓保持警惕,因为我们的患者在最初的计算机断层扫描报告中漏诊了颈内静脉血栓。