Post-cholesteatoma Lemierre syndrome: An emergency not to be overlooked.

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases Pub Date : 2026-07-27 DOI:10.1016/j.anorl.2026.02.006

F Micaletti, E Caillaud, D Bakhos

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引用次数: 0

Abstract

Introduction: Lemierre syndrome is a bacterial complication causing septic thrombosis of the head-and-neck venous network, usually with an oropharyngeal origin. Onset after otologic surgery is exceptional.

Case report: A 33-year-old woman underwent tympanoplasty for cholesteatoma; 13 days later, she developed sepsis with retroauricular scar disunion. Progression showed septic shock secondary to hemorrhagic rupture of the thrombotic lateral sinus, associated with acute respiratory distress and septic pulmonary emboli. Management required intensive care, revision surgery, antibiotic therapy and anticoagulation.

Discussion: This was a rare and serious form of Lemierre syndrome of otologic origin. It highlights the importance of considering this diagnosis in all cases of postoperative ENT sepsis with associated venous thrombosis. Treatment is based on adapted antibiotic therapy. The role of anticoagulation is debatable in the absence of solid evidence of benefit in terms of repermeabilization or survival.

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胆脂瘤后Lemierre综合征：不可忽视的紧急情况。

Lemierre综合征是一种细菌性并发症，引起头颈部静脉网络脓毒性血栓形成，通常起源于口咽。耳科手术后发病是罕见的。病例报告：一名33岁女性因胆脂瘤行鼓室成形术；13天后，患者出现脓毒症并耳后瘢痕不愈合。进展显示感染性休克继发于血栓性外侧窦出血性破裂，并伴有急性呼吸窘迫和感染性肺栓塞。治疗需要重症监护、翻修手术、抗生素治疗和抗凝治疗。讨论：这是一种罕见而严重的耳源性Lemierre综合征。它强调了在所有伴有静脉血栓形成的术后耳鼻喉败血症病例中考虑这一诊断的重要性。治疗以适应抗生素治疗为基础。抗凝的作用是有争议的，因为没有确凿的证据表明在再渗透或生存方面有益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Annals of Otorhinolaryngology-Head and Neck Diseases OTORHINOLARYNGOLOGY-

CiteScore

3.70

自引率

28.00%

发文量

审稿时长

12 days

期刊介绍： European Annals of Oto-rhino-laryngology, Head and Neck diseases heir of one of the oldest otorhinolaryngology journals in Europe is the official organ of the French Society of Otorhinolaryngology (SFORL) and the the International Francophone Society of Otorhinolaryngology (SIFORL). Today six annual issues provide original peer reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches and review articles giving most up-to-date insights in all areas of otology, laryngology rhinology, head and neck surgery. The European Annals also publish the SFORL guidelines and recommendations.The journal is a unique two-armed publication: the European Annals (ANORL) is an English language well referenced online journal (e-only) whereas the Annales Françaises d’ORL (AFORL), mail-order paper and online edition in French language are aimed at the French-speaking community. French language teams must submit their articles in French to the AFORL site. Federating journal in its field, the European Annals has an Editorial board of experts with international reputation that allow to make an important contribution to communication on new research data and clinical practice by publishing high-quality articles.