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題名 | Incomplete Lemierre Syndrome: Case Report of a 4-year-old Boy=Incomplete Lemierre Syndrome:一個4歲男童的病歷報告 |
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作者姓名(中文) | 高峻凱; 楊順成; 楊良友; 蕭建州; | 書刊名 | Chung Shan Medical Journal |
卷期 | 23:1 2012.03[民101.03] |
頁次 | 頁21-26 |
分類號 | 417.515 |
關鍵詞 | 頸靜脈栓塞; 敗血性血栓; Lemierre syndrome; Jugular vein thrombosis; Septic emboli; |
語文 | 英文(English) |
中文摘要 | Lemierre syndrome(LS)是現在比較少見的疾病,以至臨床醫師和放射科醫生可能對其較不熟悉。 LS是因為急性咽炎或口咽部細菌感染蔓延至頸部深組織,並最終導致內頸靜脈血栓性靜脈炎或栓塞。壞死梭形菌 Fusobacterium necrophorum是最常見的病原體。因為抗生素的使用,使得臨床表現出現 incomplete Lemierre syndrome的情形。今日,也許血液細菌堷養及電腦斷層掃描的結果而非病患臨床的觀察會是診斷 Lemierre syndrome的第一個線索。結合積極的抗生素治療是治療Lemierre syndrome至關重要的方式。治療使用β-lactamase–resistant的抗生素製約 3至6週,並建議做膿腫引流。在一般情況下,給予及時和適當的治療後病患可完全治癒且預後良好。雖然大多數患者是健康的青少年和年輕成年人,在此個案報告中,我們提出一個 4歲incomplete Lemierre syndrome的兒科病患,並做了一些目前文獻的探討。 |
英文摘要 | Lemierre syndrome (LS) is now relatively rare, and clinicians and radiologists in current practice may be unfamiliar with it. It presents as acute bacterial pharyngitis or oropharyngeal infections that spread to the deep cervical tissues and eventually result in internal jugular thrombophlebitis and septic embolization. Fusobacterium necrophorum is the most common etiological agent. Since the advent of antimicrobial therapy, its classical characteristics have changed to incomplete forms. Today, blood culture or computed tomography may be the first diagnostic clue, not clinical observation. The use of β-lactamase–resistant antibiotic formulations for 3 to 6 weeks and the drainage of abscesses have been advocated. In general, the prognosis for full recovery is good in patients given prompt and appropriate therapy. Although most LS patients are healthy adolescents and young adults, we present one 4-year-old pediatric patient with incomplete Lemierre syndrome and provide a review of current literature. |
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