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Volume 45, Number 1, February 2012

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


Wen-Sen Lee, Fu-Der Wang, Ying-Hua Shieh, Sing-On Teng, Tsong-Yih Ou


Received: April 20, 2010    Revised: October 20, 2010    Accepted: December 17, 2010   

 

Corresponding author:

Fu-Der Wang, Division of Infectious Disease, Department of Medicine, Taipei Veterans General Hospital, National Yang-Ming University of Medicine, Taipei, Taiwan
Corresponding author. Division of Infectious Disease, Department of Medicine, Taipei Veterans General Hospital, National Yang-Ming University of Medicine, Taipei, Taiwan.



 

Background and purpose: 

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.



 

Key words:

Brain abscess, ESBL, Fosfomycin, Klebsiella pneumoniae, Lemierre syndrome