دورية أكاديمية
أعرض في EDS

Elderly onset atypical Lemierre's syndrome concurrent with a rheumatoid vasculitis sacral ulcer infection: a case report.

التفاصيل البيبلوغرافية
العنوان: Elderly onset atypical Lemierre's syndrome concurrent with a rheumatoid vasculitis sacral ulcer infection: a case report.
المؤلفون: Mishima K; Center for Rheumatic Diseases, Matsuyama Red Cross Hospital, 1 Bunkyomachi, Ehime Prefecture, 790-8524, Matsuyama City, Japan. cozy.mishima@gmail.com., Aoki K; Center for Rheumatic Diseases, Matsuyama Red Cross Hospital, 1 Bunkyomachi, Ehime Prefecture, 790-8524, Matsuyama City, Japan., Shirai Y; Center for Rheumatic Diseases, Matsuyama Red Cross Hospital, 1 Bunkyomachi, Ehime Prefecture, 790-8524, Matsuyama City, Japan.; Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Miyagi Prefecture, Ishinomaki City, Japan., Aritomo H; Department of Otorhinolaryngology, Matsuyama Red Cross Hospital, Matsuyama City, Ehime Prefecture, Japan., Iwasaka M; Division of Dermatology, Matsuyama Red Cross Hospital, Matsuyama City, Ehime Prefecture, Japan., Katsura M; Department of Thoracic Surgery, Matsuyama Red Cross Hospital, Matsuyama City, Ehime Prefecture, Japan., Tatsutani T; Center for Rheumatic Diseases, Matsuyama Red Cross Hospital, 1 Bunkyomachi, Ehime Prefecture, 790-8524, Matsuyama City, Japan., Ikeuchi H; Center for Rheumatic Diseases, Matsuyama Red Cross Hospital, 1 Bunkyomachi, Ehime Prefecture, 790-8524, Matsuyama City, Japan., Oryoji K; Center for Rheumatic Diseases, Matsuyama Red Cross Hospital, 1 Bunkyomachi, Ehime Prefecture, 790-8524, Matsuyama City, Japan., Mizuki S; Center for Rheumatic Diseases, Matsuyama Red Cross Hospital, 1 Bunkyomachi, Ehime Prefecture, 790-8524, Matsuyama City, Japan.
المصدر: BMC infectious diseases [BMC Infect Dis] 2023 Mar 08; Vol. 23 (1), pp. 145. Date of Electronic Publication: 2023 Mar 08.
نوع المنشور: Case Reports; Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Lemierre Syndrome*/complications , Lemierre Syndrome*/diagnosis , Lemierre Syndrome*/drug therapy , Rheumatoid Vasculitis*/complications , Methicillin-Resistant Staphylococcus aureus* , Bacteremia*/diagnosis , Streptococcal Infections*/complications, Female ; Humans ; Aged ; Clindamycin ; Vancomycin ; Ulcer
مستخلص: Background: Typical Lemierre's syndrome is usually secondary to an oropharyngeal infection. Recently, several cases following a primary infection site other than the oropharynx have been reported as atypical Lemierre's syndrome; although, these primary lesions are limited to the head and neck. This is the first case potentially sequential to infectious foci outside the head and neck.
Case Presentation: We describe an atypical Lemierre's syndrome in a 72-year-old woman with rheumatoid arthritis, which occurred during the treatment of Streptococcus anginosus bacteremia acquired from a sacral ulcer infection related to rheumatoid vasculitis. At first, the symptoms resolved after the initial administration of vancomycin for the bacteremia caused by methicillin-resistant Staphylococcus aureus and Streptococcus anginosus that entered via a sacral ulcer. On the 8th day, the patient developed a fever of 40 °C and unexpectedly required 10 L of oxygen due to rapid deterioration of oxygenation temporarily. Immediately contrast-enhanced computed tomography was performed to investigate systemic thrombosis including pulmonary embolism. Afterward, the newly formed thrombi at the right external jugular vein, bilateral internal jugular veins, and the right small saphenous vein were detected, and apixaban was started. On the 9th day, the patient again had an intermittent fever of 39.7 °C, and continuous Streptococcus anginosus bacteremia was revealed; subsequently, clindamycin was administered. On the 10th day, she developed a left hemothorax; consequently, apixaban was discontinued, and a thoracic drain was inserted. She repeatedly had an intermittent fever of 40.3 °C, and contrast-enhanced computed tomography detected an abscess formation at the left parotid gland, pterygoid muscle group, and masseter muscle. After Lemierre's syndrome was diagnosed in combination with the abovementioned jugular vein thrombus, clindamycin was replaced with meropenem, and vancomycin was increased. Swelling of the lower part of the left ear became prominent with delay and peaked at approximately the 16th day. The subsequent treatment course was favorable, and she was discharged on the 41st day.
Conclusion: Clinicians should consider Lemierre's syndrome as the differential diagnosis of internal jugular vein thrombosis occurring during sepsis, even though an antibiotic is administered or a primary infection site is anything besides the oropharynx.
(© 2023. The Author(s).)
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فهرسة مساهمة: Keywords: Atypical Lemierre’s syndrome; Case report; Rheumatoid arthritis; Sacral ulcer infection; Streptococcus anginosus
المشرفين على المادة: 3U02EL437C (Clindamycin)
6Q205EH1VU (Vancomycin)
تواريخ الأحداث: Date Created: 20230308 Date Completed: 20230310 Latest Revision: 20230311
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9993631
DOI: 10.1186/s12879-023-08089-z
PMID: 36890459
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2334
DOI:10.1186/s12879-023-08089-z