セキ　マサフミ   SEK Masafumi   関　雅文    所属   埼玉医科大学  医学部 国際医療センター　感染症科・感染制御科    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読なし
表題	Lemierre's syndrome followed by acute respiratory distress syndrome successfully rescued by antibiotics and hemoperfusion with polymyxin B-immobilized fiber.
掲載誌名	正式名：Japanese journal of infectious diseases ISSNコード：13446304
巻・号・頁	62(2),133-6頁
著者・共著者	Takahiro Takazono,Koichi Izumikawa,Junji Tsurutani,Akitaka Tanaka,Tomoyuki Kakugawa,Yuichi Fukuda,Masataka Saito,Shintaro Kurihara,Yoshifumi Imamura,Masafumi Seki,Hiroshi Kakeya,Yoshihiro Yamamoto,Katsunori Yanagihara,Shigeru Kohno
発行年月	2009/03
概要	Lemierre's syndrome is characterized by a primary oropharyngeal infection in a young healthy person who subsequently develops septic thrombophlebitis of the internal jugular vein and metastatic abscesses. We here report an uncommonly severe case of Lemierre's syndrome with acute respiratory distress syndrome (ARDS), in which polymyxin B-immobilized fiber (PMX) was used as supportive therapy. A 30-year-old, previously healthy man presented with sore throat, fever, rigor, and dyspnea. Chest computed tomography scan revealed multiple bilateral peripheral pulmonary nodules with small bilateral pleural effusions. The patient's condition rapidly deteriorated into ARDS after admission. Intubation followed by mechanical ventilation was required, and hemoperfusion with PMX was useful in alleviating the patient's condition. Isolation of Fusobacterium necrophorum from the blood culture and the contrast-enhanced scan revealed thrombosis and thrombophlebitis in the left internal jugular vein. The patient was diagnosed with Lemierre's syndrome, and an alternative treatment regimen with prolonged administration of ampicillin, clindamycin, and metronidazole resulted in improvement of the patient's
PMID	19305053