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Lemierre's syndrome: A forgotten and re-emerging infection.
Journal of Microbiology, Immunology and Infection ( IF 4.5 ) Pub Date : 2020-04-04 , DOI: 10.1016/j.jmii.2020.03.027
Wen-Sen Lee , Shio-Shin Jean , Fu-Lun Chen , Szu-Min Hsieh , Po-Ren Hsueh

Lemierre's syndrome, also known as post-anginal septicemia or necrobacillosis, is characterized by bacteremia, internal jugular vein thrombophlebitis, and metastatic septic emboli secondary to acute pharyngeal infections. Modern physicians have “forgotten” this disease. The most common causative agent of Lemierre's syndrome is Fusobacterium necrophorum, followed by Fusobacterium nucleatum and anaerobic bacteria such as streptococci, staphylococci, and Klebsiella pneumoniae. The causative focus mostly originated from pharyngitis or tonsillitis, accounting for over 85% of the cases of Lemierre's syndrome. Pneumonia or pleural empyema is the most common metastatic infection in Lemierre's syndrome. Antimicrobial therapy should be prescribed for 3–6 weeks. The treatment regimens include metronidazole and β-lactam antibiotics. In recent years, the antibiotic stewardship program has resulted in decreased antibiotic prescription for upper respiratory tract infections. The incidence of Lemierre's syndrome has increased over the past decade. F. necrophorum is an underestimated cause of acute pharyngitis or tonsillitis. A high index of suspicion is required for the differential diagnosis of acute tonsillopharyngitis with persistent neck pain and septic syndrome.



中文翻译:

Lemierre综合征:一种被遗忘并重新出现的感染。

Lemierre综合征,也称为心绞痛后败血病或坏死杆菌病,其特征是菌血症,颈内静脉血栓性静脉炎和继发于急性咽部感染的转移性败血栓子。现代医生已经“忘记”了这种疾病。Lemierre综合征最常见的病原体是坏死镰刀菌,其次是核镰刀菌和厌氧菌,如链球菌,葡萄球菌和肺炎克雷伯菌。病因主要来自咽炎或扁桃体炎,占Lemierre综合征病例的85%以上。肺炎或胸膜积脓是Lemierre综合征中最常见的转移性感染。应开3-6周的抗菌治疗。治疗方案包括甲硝唑和β-内酰胺类抗生素。近年来,抗生素管理计划导致减少了上呼吸道感染的抗生素处方。过去十年里,勒米耶氏综合症的发病率有所增加。坏死镰刀菌被低估为急性咽炎或扁桃体炎的原因。鉴别诊断为持续性颈部疼痛和败血综合症的急性扁桃体咽喉炎需要高度怀疑。

更新日期:2020-04-04
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