Gato A, García Aguado C, Mateo O, Pontes M J, Baez B, Pérez V
Servicio de Medicina Interna, Hospital Universitario de Getafe, Madrid.
Enferm Infecc Microbiol Clin. 1993 May;11(5):263-6.
The Lemierre syndrome is a septic picture with jugular thrombophlebitis and secondary septic embolisms usually produced by Fusobacterium necrophorum. In previous reports published in the literature, imaging techniques are seldom referred to report the presence of jugular thrombophlebitis. A case of the Lemierre syndrome is presented with the aim of calling attention to this process and its current diagnostic possibilities.
The case of a patient who was diagnosed of having a Lemierre syndrome with sepsis by Fusobacterium is presented, with radiologic pulmonary embolisms. The echo-Doppler exam showed the presence of internal jugular involvement in absence of signs and symptoms leading to suspicion. A review of 6 cases is also made with special attention being given to the data on jugular vein involvement.
Only in 2 of the 6 patients reviewed were imaging techniques used on the internal jugular view (in one 2D echography and in the other computerized axial tomography) with the diagnosis being performed on the base of symptomatic and physical exam data in the remaining 4 cases.
The Lemierre syndrome should be suspect in all patients with bacteremia by Fusobacterium and radiologic imaging of pulmonary embolism, even in the absence of signs and symptoms of oropharyngeal and jugular involvement. Modern imaging techniques, particularly echo-Doppler, may play an important diagnostic role.
勒米尔综合征是一种伴有颈静脉血栓性静脉炎和继发性脓毒性栓塞的脓毒症表现，通常由坏死梭杆菌引起。在以往文献报道中，很少提及利用影像学技术来报告颈静脉血栓性静脉炎的存在情况。本文报告一例勒米尔综合征病例，旨在引起对该病症及其当前诊断可能性的关注。
本文介绍了一例被诊断为坏死梭杆菌所致脓毒症性勒米尔综合征且伴有放射性肺栓塞的患者病例。超声多普勒检查显示，在无引发怀疑的体征和症状情况下，颈内静脉受累。同时还回顾了6例病例，并特别关注颈静脉受累的数据。
在回顾的6例患者中，只有2例对颈内静脉进行了影像学检查（1例采用二维超声检查，另1例采用计算机断层扫描），其余4例根据症状和体格检查数据进行诊断。
对于所有坏死梭杆菌所致菌血症且伴有肺栓塞放射性影像的患者，即使没有口咽和颈静脉受累的体征和症状，也应怀疑为勒米尔综合征。现代影像学技术，尤其是超声多普勒，可能发挥重要的诊断作用。
