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糖尿病患者因[未提及具体病因]导致的勒米尔综合征引发肺脓肿并发症:一例罕见病例报告

Lemierre's Syndrome Due to Results in Pulmonary Abscess Complications in a Patient With Diabetes: A Rare Case Report.

作者信息

Ngo Trung Dinh, Nguyen Cuong Thai, Ho Nam

机构信息

Surgical and Transplant Intensive Care Unit, 108 Military Central Hospital, Hanoi, Vietnam.

出版信息

Case Rep Infect Dis. 2024 Dec 23;2024:8176530. doi: 10.1155/crdi/8176530. eCollection 2024.

DOI:10.1155/crdi/8176530
PMID:39741700
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11685315/
Abstract

Lemierre's syndrome (LS), first described by Andre Lemierre in the early 20th century, is a rare but potentially life-threatening condition typically caused by . However, recent literature has reported cases of LS caused by various other bacteria, including . In this report, we present a rare case of LS in a patient with diabetes caused by . A 62-year-old Vietnamese male with a history of type 2 diabetes mellitus, presented with an 8-day history of progressive left neck swelling, fever, dysphagia, odynophagia, and reduced appetite. Despite initial antibiotic therapy, his condition deteriorated, leading to pulmonary abscesses and septic shock. Abscess content culture revealed K. pneumoniae. The patient required intubation, mechanical ventilation, and surgical drainage of the neck abscess. Treatment with meropenem, along with glycemic control, led to clinical improvement. The patient was subsequently extubated, achieved complete wound healing, and was discharged with normal biochemical parameters. This case highlights that LS can be caused by pathogens not initially outlined by Andre Lemierre, such as . Clinicians should consider a broader spectrum of causative organisms when there is a strong clinical suspicion of LS and adjust antimicrobial coverage accordingly. The association between -related LS and diabetes mellitus warrants further investigation, as current evidence suggests that diabetes may predispose patients to this particular pathogen.

摘要

勒米尔综合征(LS)最早由安德烈·勒米尔在20世纪初描述,是一种罕见但可能危及生命的疾病,通常由……引起。然而,最近的文献报道了由包括……在内的各种其他细菌引起的LS病例。在本报告中,我们介绍了一例由……引起的糖尿病患者罕见的LS病例。一名62岁有2型糖尿病病史的越南男性,出现进行性左颈部肿胀、发热、吞咽困难、吞咽疼痛和食欲减退8天。尽管最初进行了抗生素治疗,但其病情仍恶化,导致肺脓肿和感染性休克。脓肿内容物培养显示为肺炎克雷伯菌。患者需要插管、机械通气以及颈部脓肿的外科引流。美罗培南治疗联合血糖控制导致临床症状改善。患者随后拔管,伤口完全愈合,出院时生化指标正常。 该病例突出表明,LS可由安德烈·勒米尔最初未概述的病原体引起,如……。当临床高度怀疑LS时,临床医生应考虑更广泛的致病生物谱并相应调整抗菌药物覆盖范围。与……相关的LS和糖尿病之间的关联值得进一步研究,因为目前的证据表明糖尿病可能使患者易感染这种特定病原体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/680f/11685315/c33aa80ac40b/CRIID2024-8176530.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/680f/11685315/3d82df23c51d/CRIID2024-8176530.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/680f/11685315/4064dee2c87d/CRIID2024-8176530.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/680f/11685315/45f947557903/CRIID2024-8176530.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/680f/11685315/84796922317a/CRIID2024-8176530.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/680f/11685315/c33aa80ac40b/CRIID2024-8176530.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/680f/11685315/3d82df23c51d/CRIID2024-8176530.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/680f/11685315/4064dee2c87d/CRIID2024-8176530.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/680f/11685315/45f947557903/CRIID2024-8176530.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/680f/11685315/84796922317a/CRIID2024-8176530.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/680f/11685315/c33aa80ac40b/CRIID2024-8176530.005.jpg

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本文引用的文献

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Lemierre's syndrome associated with hypervirulent A case report and genomic characterization of the isolate.与高毒力相关的勒米尔综合征:一例病例报告及分离株的基因组特征分析
IDCases. 2021 May 28;25:e01173. doi: 10.1016/j.idcr.2021.e01173. eCollection 2021.
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Lemierre's syndrome caused by in an elderly woman.一名老年女性因[具体病因未给出]引发的勒米尔综合征。
J Vasc Surg Cases Innov Tech. 2020 Feb 4;6(1):31-33. doi: 10.1016/j.jvscit.2019.11.007. eCollection 2020 Mar.
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An unusual cause of Lemierre Syndrome.一种不常见的林氏综合征病因。
J Stomatol Oral Maxillofac Surg. 2019 Sep;120(4):358-360. doi: 10.1016/j.jormas.2019.02.009. Epub 2019 Feb 14.
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Update: Surviving Sepsis Campaign recommends Hour-1 bundle use.最新消息:拯救脓毒症运动推荐使用1小时集束治疗。
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