Faussat J M, Coste A, Roger G, Page B, Marrek H, Roulleau P
Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Necker Enfants-Malades, Paris.
Ann Otolaryngol Chir Cervicofac. 1993;110(8):445-9.
While before antibiotics cases of septic thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection were frequent and had a poor prognosis, today they are exceptional and often have a favourable course under antibiotic therapy. The clinical features are often limited to fever and a painful tumefaction of the anterior border of the sterno-cleido-mastoidian muscle, symptoms may be more pronounced in the Lemierre syndrome in which the anaerobic septicaemia is associated with secondary, especially pleuro-pulmonary, localizations. The diagnosis can be confirmed with a cervical CT-scan showing an enlarged, thrombosed vein which does not opacify and has a hyperdense periphery. Treatment is based on parenteral antibiotics adapted to anaerobic germs.
在抗生素出现之前，口咽感染继发的颈内静脉化脓性血栓性静脉炎病例很常见且预后较差，而如今这类病例已较为罕见，并且在抗生素治疗下通常病程良好。临床特征往往仅限于发热以及胸锁乳突肌前缘的疼痛性肿胀，在勒米尔综合征中症状可能更明显，该综合征中厌氧败血症伴有继发性局部感染，尤其是胸膜肺部感染。通过颈部CT扫描可确诊，扫描显示静脉扩张、血栓形成且不显影，周边密度增高。治疗基于针对厌氧病菌的胃肠外抗生素。
