ABSTRACT
A tromboflebite supurativa da veia jugular interna ou síndrome de Lemierre foi descrita pela primeira vez em 1900. O evento inicial mais frequente é a infecção de orofaringe associada à trombose da veia jugular interna. Embora uma entidade rara, a síndrome de Lemierre continua a ser uma doença de morbidade e mortalidade consideráveis devido à sua progressão e atrasos de diagnóstico.
Suppurative thrombophlebitis of the internal jugular vein, or Lemierre syndrome, was described for the first time in 1900. The most common initial event is an infection of the oropharynx associated with thrombosis of the internal jugular vein. While it is a rare entity, Lemierre syndrome remains a disease that causes considerable morbidity and mortality, due to its progression and to delays in diagnosis.
Subject(s)
Humans , Female , Adolescent , Ceftriaxone/therapeutic use , Clindamycin/therapeutic use , Penicillins , Lemierre Syndrome/diagnosis , Lemierre Syndrome/drug therapy , Lemierre Syndrome/therapy , Anticoagulants/therapeutic use , Time Factors , Tomography, X-Ray ComputedABSTRACT
El síndrome de Lemierre es una complicación muy poco frecuente de una infección orofaríngea, que progresa con tromboflebitis séptica secundaria e infecciones embólicas frecuentes. Presentamos el caso de una mujer de 20 años que inició un cuadro de odinofagia y fiebre, el cual progresó rápidamente a un absceso periamigdalino con trombosis de la vena yugular interna ipsilateral, embolias sépticas pulmonares y meningitis. Se manejó con drenaje del absceso por punción, terapia antibiótica de amplio espectro y anticoagulación respondiendo favorablemente, siendo dada de alta en buenas condiciones luego de 35 días de hospitalización. Con la terapia antimicrobiana, casos como éste son poco frecuentes, incluso a veces olvidados, pero dado su gravedad deben considerarse en cuadros faríngeos de evolución tórpida o ante la aparición de signos neurológicos o sépticos.
Lemierre syndrome is a rare complication of oropharyngeal infection which progresses with secondary septic thrombophlebitis and embolic infections. A 20 years-old woman started with odynophagia and fever, which progressed rapidly to a peritonsillar abscess with thrombosis of the ipsilateral internal jugular vein, septic pulmonary emboli and meningitis. She was managed with abscess drainage puncture, broad-spectrum antibiotic therapy and anticoagulant responding favorably, and was discharged in good condition after 35 days of hospitalization. Since the use of antimicrobial therapy, cases like these are rare, sometimes forgotten, but given its severity should be considered in pharyngeal torpid illness or at the onset of neurological signs or sepsis.