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