Fabozzi Antonio, Siena Alessandro, Steffanina Alessia, Iannuzzi Silvia, Bonini Matteo, Palange Paolo
Department of Public Health and Infectious Diseases, Pulmonology Unit, Policlinico Umberto I "Sapienza" University of Rome Rome Italy.
Respirol Case Rep. 2025 Jul 15;13(7):e70266. doi: 10.1002/rcr2.70266. eCollection 2025 Jul.
Lemierre syndrome (LS) is a rapidly progressing disease characterised by a recent oropharyngeal infection, complicated by septic emboli and thrombophlebitis of the internal jugular vein (IJV). We describe a case of a 65-year-old woman who presented to the emergency room with a 14-day history of progressive occipital headache, fever and odynophagia. Radiological investigations showed bilateral IJV thrombophlebitis, multiple cavitated pulmonary nodules suggestive of septic emboli and a subsegmental pulmonary arterial thromboembolism. A diagnosis of LS was made. The patient received antibiotic treatment with intravenous ceftriaxone and clindamycin for 2 weeks, followed by 4 weeks of oral clindamycin at home and anticoagulation with enoxaparin followed by warfarin. One-month follow-up imaging revealed complete resolution of IJV thrombosis and pulmonary findings. This case displayed the rarely reported association of pulmonary arterial thromboembolism and pulmonary septic emboli.
勒米尔综合征（LS）是一种进展迅速的疾病，其特征为近期有口咽感染，并伴有脓毒性栓子和颈内静脉（IJV）血栓性静脉炎。我们报告一例65岁女性，因进行性枕部头痛、发热和吞咽痛14天就诊于急诊室。影像学检查显示双侧IJV血栓性静脉炎、多个有空洞的肺结节提示脓毒性栓子以及亚段肺动脉血栓栓塞。诊断为LS。患者接受了静脉注射头孢曲松和克林霉素抗生素治疗2周，随后在家口服克林霉素4周，并使用依诺肝素抗凝，之后改为华法林抗凝。1个月的随访影像学检查显示IJV血栓形成和肺部病变完全消退。该病例展示了肺动脉血栓栓塞与肺脓毒性栓子之间罕见的关联。
