|
Lemierre's syndrome (or Lemierre's disease, also known as postanginal shock including sepsis and human necrobacillosis) refers to thrombophlebitis of the internal jugular vein. It most often develops as a complication of a bacterial sore throat infection in young, otherwise healthy adults. The thrombophlebitis is a serious condition and may lead to further systemic complications such as bacteria in the blood or septic emboli. Lemierre's syndrome occurs most often when a bacterial (e.g. Fusobacterium necrophorum) throat infection progresses to the formation of a peritonsillar abscess. Deep in the abscess, anaerobic bacteria can flourish. When abscess wall ruptures internally, the drainage carrying bacteria seeps through the soft tissue and infects the nearby structures. Spread of infection to the nearby jugular vein provides a gateway for the spread of bacteria through the bloodstream. The inflammation surrounding the vein and compression of the vein may lead to clot formation. Pieces of the potentially infected clot break off and travel through the right heart onto the lungs as emboli, blocking branches of the pulmonary artery that carry deoxygenated blood from the heart to the lungs. Sepsis following from a throat infection was described by Scottmuller in 1918. However it was André Lemierre, in 1936, who published a series of 20 cases where throat infections were followed by identified anaerobic septicemia, of whom 18 patients died. ==Signs and symptoms== The symptoms vary, but usually start with a sore throat, fever, and general body weakness. These are followed by extreme lethargy, spiked fevers, rigors, swollen cervical lymph nodes, and a swollen, tender or painful neck. Often there is abdominal pain, diarrhea, nausea and vomiting during this phase. These signs and symptoms usually occur several days to 2 weeks after the initial symptoms. Symptoms of pulmonary involvement can be shortness of breath, cough and painful breathing (pleuritic chest pain). Rarely, blood is coughed up. Painful or inflamed joints can occur when the joints are involved. Septic shock can also arise. This presents with low blood pressure, increased heart rate, decreased urine output and an increased rate of breathing. Some cases will also present with meningitis, which will typically manifest as neck stiffness, headache and sensitivity of the eyes to light. Liver enlargement and spleen enlargement can be found, but are not always associated with hepatic or splenic abscesses.〔〔 Other signs and symptoms that may occur: * Headache (unrelated to meningitis) * Memory loss * Muscle pain * Jaundice * Decreased ability to open the jaw * Crepitations are sometimes heard over the lungs * Pericardial friction rubs as a sign of pericarditis (rare) * Cranial nerve paralysis and Horner's syndrome (both rare) 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Lemierre's syndrome」の詳細全文を読む スポンサード リンク
|