Nakahara Sayaka, Obata Kaoru, Ikegami Tetsunori
Emergency and Critical Care Center, Kurashiki Central Hospital, Miwa, Kurashiki, Okayama, Japan.
Department of Neurology, Kurashiki Central Hospital, Miwa, Kurashiki, Okayama, Japan.
J Emerg Trauma Shock. 2024 Jul-Sep;17(3):184-186. doi: 10.4103/jets.jets_5_24. Epub 2024 Aug 2.
Lemierre's syndrome is a rare disease characterized by thrombophlebitis of the internal jugular vein and metastasis to distant organs. It occurs after an anaerobic infection of the larynx or dental region; the central nervous system involvement is infrequent. A 50-year-old woman presented with impaired consciousness. She had undergone several days of dental treatment for a toothache before presentation. Contrast-enhanced computed tomography (CT) revealed a head-and-neck abscess and a massive thrombus in the internal jugular vein, and a diagnosis of Lemierre's syndrome was made. After symptoms improved with surgical drainage and antimicrobial therapy, the patient was discharged on day 58. In this case, Lemierre's syndrome was complicated by a venous stroke caused by venous congestion due to a massive cerebral venous thrombus. Venous stroke due to thrombi may occur in patients with Lemierre's syndrome, and magnetic resonance imaging or CT with venous phase imaging may aid in the diagnosis.
勒米尔综合征是一种罕见疾病，其特征为颈内静脉血栓性静脉炎并转移至远处器官。它发生于喉部或口腔区域的厌氧菌感染之后；中枢神经系统受累并不常见。一名50岁女性出现意识障碍。她在就诊前因牙痛接受了数天的牙科治疗。增强计算机断层扫描（CT）显示头颈部脓肿及颈内静脉内巨大血栓，遂诊断为勒米尔综合征。经手术引流及抗菌治疗症状改善后，患者于第58天出院。在该病例中，勒米尔综合征因巨大脑静脉血栓导致的静脉淤血并发静脉性卒中。勒米尔综合征患者可能发生血栓所致的静脉性卒中，磁共振成像或静脉期成像的CT有助于诊断。
