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.
Copyright © 2011. Published by Elsevier B.V.
MeSH terms
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Anti-Bacterial Agents / administration & dosage
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Brain / diagnostic imaging
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Brain Abscess / complications*
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Brain Abscess / drug therapy
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Brain Abscess / microbiology
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Community-Acquired Infections / diagnosis
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Community-Acquired Infections / drug therapy
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Community-Acquired Infections / microbiology
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Community-Acquired Infections / pathology
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Drug Therapy, Combination / methods
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Female
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Fosfomycin / administration & dosage*
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Humans
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Infusions, Intravenous
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Klebsiella Infections / diagnosis*
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Klebsiella Infections / drug therapy
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Klebsiella Infections / microbiology
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Klebsiella Infections / pathology
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Klebsiella pneumoniae / enzymology*
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Klebsiella pneumoniae / isolation & purification
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Lemierre Syndrome / diagnosis*
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Lemierre Syndrome / drug therapy
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Lemierre Syndrome / microbiology
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Lemierre Syndrome / pathology
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Meropenem
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Middle Aged
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Sepsis / diagnosis
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Sepsis / drug therapy
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Sepsis / microbiology
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Sepsis / pathology
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Thienamycins / administration & dosage*
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Tomography, X-Ray Computed
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Treatment Outcome
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beta-Lactamases / metabolism*
Substances
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Anti-Bacterial Agents
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Thienamycins
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Fosfomycin
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beta-Lactamases
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Meropenem