García Romero José Manuel, Jaime Vargas Fatima Paulina, Bravo Quiroz José Gonzalo, Pérez Mondragón Diana, Hernández Guillen Pablo
Transplant and Donation Department, Regional General Hospital 1 of the Mexican Institute of Social Security, Querétaro, MEX.
General Practice Department, Centro de Salud Pedro Escobedo, Secretaría de Salud, Querétaro, MEX.
Cureus. 2024 Jul 21;16(7):e65060. doi: 10.7759/cureus.65060. eCollection 2024 Jul.
Lemierre's syndrome, a rare complication of oropharyngeal infections, is characterized by septic thrombophlebitis primarily affecting the internal jugular vein, which can lead to septicemia, thrombotic obstruction, and potential dissemination to distant sites. We present the case of a 54-year-old male with a history of chronic smoking and newly diagnosed laryngeal carcinoma, complicated by Lemierre's syndrome. Initial symptoms included odynophagia, dyspnea, and cervical swelling, with subsequent diagnosis confirming thrombosis of the internal jugular vein via ultrasound, CT, and MRI. Treatment included broad-spectrum antibiotics and anticoagulation, followed by oncological management for the carcinoma. This case underscores the diagnostic challenge posed by concurrent malignancy and highlights the critical role of early recognition and comprehensive treatment involving antibiotics, anticoagulation, and oncological therapy. Multidisciplinary collaboration is crucial for optimizing outcomes in complex cases like this, emphasizing the need for heightened clinical suspicion and prompt intervention involving proper imaging diagnosis, appropriate antibiotic coverage, and timely microbiological recognition for adjustment of antimicrobial therapy.
勒米尔综合征是口咽感染的一种罕见并发症，其特征为主要影响颈内静脉的化脓性血栓性静脉炎，可导致败血症、血栓形成阻塞，并可能扩散至远处部位。我们报告一例54岁男性病例，该患者有长期吸烟史，新诊断为喉癌，并并发勒米尔综合征。初始症状包括吞咽痛、呼吸困难和颈部肿胀，随后通过超声、CT和MRI确诊为颈内静脉血栓形成。治疗包括使用广谱抗生素和抗凝治疗，随后对癌症进行肿瘤学管理。该病例强调了并发恶性肿瘤所带来的诊断挑战，并突出了早期识别以及包括抗生素、抗凝治疗和肿瘤治疗在内的综合治疗的关键作用。多学科协作对于优化此类复杂病例的治疗结果至关重要，强调需要提高临床怀疑度并及时进行干预，包括适当的影像诊断、合适的抗生素覆盖范围以及及时进行微生物学鉴定以调整抗菌治疗。
