摘要
拉米爾氏症(Lemierre syndrome)是一個罕見而幾乎被遺忘的疾病，它常因口咽或頭頸部的厭氧菌感染，造成內頸靜脈血栓靜脈炎，甚至可能導致菌血症、細菌性血栓散佈到全身如腦、眼、肺、心、肝、腎、關節、骨髓、皮膚等處造成許多併發症。在抗生素尚未發明的時代，它致命的機率是很高的。本院於2006年6月經歷1名26歲男性，主訴發燒、喉嚨痛和左頸部胸鎖乳突肌周圍疼痛，住院後的頸部電腦斷層掃描及核磁共振顯示有左側內頸靜脈血栓、左側肋膜積水、肺部栓塞。血液也培養出梭狀菌(Fusobacterium necrophorum)，證實是拉米爾氏症。在抗生素治療後，病人恢復狀況良好，無併發症，並持續於門診追蹤。
並列摘要
Lemierre syndrome is rare and the disease is usually caused by a member of the Fusobacteria, anaerobic organisms that are a normal part of the oropharyngeal flora. The disease leads to the formation of an infected thrombus within the internal jugular vein. Many of the resulting symptoms are due to dissemination of septic emboli to other areas of the body. This disease vanished from sight with the advent of antibiotics but has now returned decades later. It has been called the ”forgotten disease”. A 26- year-old male presented at our hospital with fever, a sore throat and left side neck pain. A contrast-enhanced computed tomography (CT) scan and MRI showed a thrombus in left internal jugular vein, pulmonary embolism and left pleural effusions. A blood culture showed the presence of Fusobacterium necrophorum which is compatible with Lemierre syndrome. On discharge, the patient was given a complete course of oral antibiotics (Augmentin) and recovered well without any complications.
延伸閱讀
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- Chen, C. H., Lin, C. H., Chin, C. H., Chiu, M. H., & Chen, P. H. (2005). Lemierre's Syndrome. Journal of Medical Ultrasound, 13(3), 149-152. https://www.airitilibrary.com/Article/Detail?DocID=09296441-200509-13-3-149-152-a