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Lemierre syndrome complicating multiple brain abscesses caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae cured by fosfomycin and meropenem combination therapy.

Abstract
A woman aged 56 years of age had a community-acquired left neck abscess and internal jugular vein thrombosis with septicemia due to extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae. Even though she was treated with intravenous meropenem, the bacteremia persisted. She was complicated with multiple brain abscesses, seizure, and leucopenia. After a combination of intravenous fosfomycin and meropenem, her clinical condition became stable. Combination treatment was continued for 2 months and she recovered. In individual cases of Lemierre syndrome with brain abscess caused by ESBL-producing Enterobacteriaceae, fosfomycin combination therapy may be the alternative choice.
AuthorsWen-Sen Lee, Fu-Der Wang, Ying-Hua Shieh, Sing-On Teng, Tsong-Yih Ou
JournalJournal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi (J Microbiol Immunol Infect) Vol. 45 Issue 1 Pg. 72-4 (Feb 2012) ISSN: 1995-9133 [Electronic] England
PMID22154996 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2011. Published by Elsevier B.V.
Chemical References
  • Anti-Bacterial Agents
  • Thienamycins
  • Fosfomycin
  • beta-Lactamases
  • Meropenem
Topics
  • Anti-Bacterial Agents (administration & dosage)
  • Brain (diagnostic imaging)
  • Brain Abscess (complications, drug therapy, microbiology)
  • Community-Acquired Infections (diagnosis, drug therapy, microbiology, pathology)
  • Drug Therapy, Combination (methods)
  • Female
  • Fosfomycin (administration & dosage)
  • Humans
  • Infusions, Intravenous
  • Klebsiella Infections (diagnosis, drug therapy, microbiology, pathology)
  • Klebsiella pneumoniae (enzymology, isolation & purification)
  • Lemierre Syndrome (diagnosis, drug therapy, microbiology, pathology)
  • Meropenem
  • Middle Aged
  • Sepsis (diagnosis, drug therapy, microbiology, pathology)
  • Thienamycins (administration & dosage)
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • beta-Lactamases (metabolism)

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