A Case of Lemierre's Syndrome Associated with Necrotizing Fasciitis and Septic Embolization

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  • Suzuki Kiyozumi
    Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine Department of General Medicine, Juntendo University School of Medicine
  • Hayashi Yuta
    Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine
  • Otsuka Hiromasa
    Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine
  • Orita Minori
    Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine
  • Kuwana Tsukasa
    Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine
  • Hashimoto Kenichi
    Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine
  • Kasamaki Yuji
    Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine
  • Yanai Mitsuru
    Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine
  • Kinoshita Kosaku
    Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine
  • Soma Masayoshi
    Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine

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Other Title
  • 壊死性筋膜炎，敗血症性肺塞栓症を合併したLemierre症候群の1例
  • 今月の症例 壊死性筋膜炎,敗血症性肺塞栓症を合併したLemierre症候群の1例
  • コンゲツ ノ ショウレイ エシセイキンマクエン,ハイケツショウセイ ハイ ソクセンショウ オ ガッペイ シタ Lemierre ショウコウグン ノ 1レイ

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Abstract

<p>46歳，男性．発熱，咽頭痛，呼吸困難のため救急搬送となった．両側の扁桃周囲膿瘍，右内頸静脈血栓，敗血症性肺塞栓症の画像所見に加えて，右肩および右膝の壊死性筋膜炎を認め，血液，扁桃周囲膿瘍，右肩皮下膿瘍の培養からFusobacterium necrophorumが検出された．Lemierre症候群（Lemierre's syndrome：LS）と診断し，抗菌薬投与，デブリドマン，抗凝固療法を行い，軽快した．LSは致死的な感染症であり，稀ながら壊死性筋膜炎を合併し得ることに留意する必要がある．</p>

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