Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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A Case of Lemierre Syndrome Manifests with Persistent Fever and Neck Stiffness Following Acute Oropharyngeal Infection

급성 입인두 감염 후에 발열과 경부 강직을 주소로 내원한 Lemierre 증후군 1례

  • Lee, Yena (Department of Pediatrics, Soonchunhyang University Hospital) ;
  • Hong, Ye-Seul (Department of Pediatrics, Soonchunhyang University Hospital) ;
  • Kim, Sung Soo (Department of Pediatrics, Soonchunhyang University Hospital)
  • 이예나 (순천향대학교 구미병원 소아청소년과) ;
  • 홍예슬 (순천향대학교 구미병원 소아청소년과) ;
  • 김성수 (순천향대학교 구미병원 소아청소년과)
  • Received : 2015.11.05
  • Accepted : 2016.01.09
  • Published : 2016.08.25
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Abstract

Lemierre syndrome is a rare disease involving multiple organs affected by septic emboli following oropharyngeal infection. After the introduction of penicillin in the 1940s, it became a "forgotten" disease. However, due to the development of diagnostic image modalities including neck computed tomography (CT) scan, the number of published reports of Lemierre syndrome and diagnosis has been increasing since the 1990s. In this report, we describe a case of Lemierre syndrome, following oropharyngeal infection in a 16-year-old patient, who manifested with persistent fever and neck stiffness. Neck ultrasonography confirmed thrombus formation in the right internal jugular vein without definite evidence of septic emboli to other organs. After the three-week-long antibiotics therapy was completed, the thrombus in the right internal jugular vein finally disappeared.

Lemierre 증후군은 급성 입인두 감염의 합병증으로 생기는 질환으로, 이차적인 혈전 정맥염과 여러 장기를 침범하는 전이성 색전이 특징이다. 1940년대 이후 항생제가 도입되면서 "잊혀진" 질환이었지만, 영상의학 검사가 발달하면서 Lemierre 증후군의 보고가 많아지고 있다. 건강한 16세 남자 환자가 입인두 감염 후에 5일간 지속된 발열과 경부 강직으로 응급실에 내원하였다. 입원 초기에는 뇌수막염에 준하여 치료를 시작하였으나 추후 경부 전산화 단층촬영에서 오른쪽 속목정맥 안의 혈전이 발견되어 Lemierre 증후군으로 진단하였다. 환자는 입원 2일째 갑자기 복시를 호소하였으나 곧 증상이 호전되었으며, 그 외 전이성 색전에 의한 증상은 발견되지 않았다. 총 3주간의 항생제 치료 후 정맥 내 혈전이 소실된 것을 경부 초음파로 확인하고 치료를 종료하였다.

Keywords

References

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