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J R Coll Physicians Edinb ; 53(4): 258-262, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37675957

RESUMEN

Infection is a rare cause of panhypopituitarism and has not been reported in the context of Lemierre's syndrome. We present the case of a previously well 19-year-old man, who presented acutely unwell with meningitis and sepsis. Fusobacterium necrophorum was isolated from peripheral blood cultures and identified on cerebrospinal fluid with 16S rDNA Polymerase Chain Reaction (PCR). Imaging demonstrated internal jugular vein thrombosis with subsequent cavernous venous sinus thrombosis. Pituitary function tests were suggestive of panhypopituitarism. The patient was diagnosed with Lemierre's syndrome complicated by meningitis, cavernous sinus thrombosis, base of skull osteomyelitis, ischaemic stroke and panhypopituitarism. He was treated with 13 weeks of intravenous antibiotics followed by 3 weeks of oral amoxicillin, and anticoagulated with dalteparin then apixaban. His panhypopituitarism was managed with hydrocortisone, levothyroxine and desmopressin.


Asunto(s)
Isquemia Encefálica , Trombosis del Seno Cavernoso , Accidente Cerebrovascular Isquémico , Síndrome de Lemierre , Meningitis , Embolia Pulmonar , Accidente Cerebrovascular , Masculino , Humanos , Adulto Joven , Adulto , Síndrome de Lemierre/complicaciones , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/tratamiento farmacológico , Trombosis del Seno Cavernoso/etiología , Trombosis del Seno Cavernoso/complicaciones , Isquemia Encefálica/complicaciones , Embolia Pulmonar/complicaciones , Embolia Pulmonar/tratamiento farmacológico , Accidente Cerebrovascular Isquémico/complicaciones , Meningitis/complicaciones
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