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Tromboflebitis facial aislada causada por Fusobacterium nucleatum: un caso de la variante de Lemierre
Nicole Oska1, Deni Peterson1, Kendall Brothers1
1School of Medicine, Wayne State University, Detroit, Michigan, USA.
Case reports in infectious diseases
|August 27, 2025
Resumen
El síndrome de Lemierre, una infección rara pero grave, puede ocurrir con faringitis. Este caso destaca la trombosis de las venas faciales causada por Fusobacterium nucleatum, haciendo hincapié en el diagnóstico temprano y el tratamiento para prevenir complicaciones graves.
Área de la Ciencia:
- Enfermedades infecciosas
- Medicina vascular
- Microbiología
Sus antecedentes:
- El síndrome de Lemierre es una infección rara y potencialmente mortal que a menudo se deriva de una faringitis bacteriana.
- Por lo general, incluye bacteriemia, con frecuencia con Fusobacterium necrophorum, y tromboflebitis de la vena yugular interna.
- Los casos no tratados pueden conducir a una embolización séptica que afecta a los órganos vitales.
Objetivo del estudio:
- Para reportar una variante del síndrome de Lemierre que involucra la tromboflebitis de las venas faciales.
- Destacar la importancia del diagnóstico y tratamiento tempranos en las presentaciones atípicas.
- Para hacer hincapié en Fusobacterium nucleatum como agente causal.
Principales métodos:
- Informe de caso de una mujer de 33 años con faringitis estreptocócica.
- La presentación clínica incluyó dolor facial y de cuello, rigores y fiebre.
- Las herramientas de diagnóstico incluyeron cultivos de sangre y venografía por TC.
Principales resultados:
- Los cultivos de sangre identificaron bacteriemia por Fusobacterium nucleatum.
- El venograma CT confirmó una trombosis aislada de la vena facial derecha.
- El paciente recibió un ciclo de 4 semanas de metronidazol y 2 semanas de ceftriaxona.
Conclusiones:
- Este caso subraya la necesidad de sospechar el síndrome de Lemierre en la faringitis bacteriana, incluso con dolor facial atípico.
- La trombosis de la vena facial es una manifestación posible, distinta de la participación más común de la vena yugular interna.
- El tratamiento antibiótico inmediato es esencial para evitar resultados graves como el shock séptico y la embolización.
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