Onozawa Shinichi, Someya Fujiko, Yokogawa Masami
Rehabilitation Center, Asanogawa General Hospital, Kanazawa, JPN.
Department of Physical Therapy, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, JPN.
Cureus. 2023 Sep 19;15(9):e45533. doi: 10.7759/cureus.45533. eCollection 2023 Sep.
Lemierre's syndrome (LS) is a severe infectious disease that can lead to the formation of neck abscesses and thrombosis. LS may be an indication for surgery; however, there are few reports on the physical therapy approaches used in patients with LS. A male patient in his 20s reported atelectasis and limited range of motion in the neck after resection of a deep neck abscess on the left side of the neck caused by LS. Thrombophlebitis was also observed around the neck lesion, indicating the risk of pulmonary embolism. Physical therapy was initiated with low-load, deep breathing exercises. Additional breathing exercises, such as respiratory assistance and positive pressure loading, were initiated after the administration of anticoagulants. Although the therapeutic intervention was delayed due to the unstable wound with partially resected muscle, it was assumed that the impairment of the range of motion in the neck was unlikely to persist as the patient was young. No critical adverse events were observed, and the range of motion was recovered such that the patient was able to resume playing baseball. The presence of a venous thrombus and inflammation may affect physical therapy; however, careful management of the exercise load could aid in the safe and effective treatment of LS without the incidence of complications, even in the early postoperative period.
勒米尔综合征（LS）是一种严重的传染病，可导致颈部脓肿和血栓形成。LS可能需要手术治疗；然而，关于LS患者所采用的物理治疗方法的报道很少。一名20多岁的男性患者在切除由LS引起的左侧颈部深部脓肿后，出现肺不张和颈部活动范围受限。在颈部病变周围还观察到血栓性静脉炎，提示有肺栓塞风险。物理治疗从低负荷深呼吸练习开始。在给予抗凝剂后，开始进行额外的呼吸练习，如呼吸辅助和正压负荷。尽管由于伤口不稳定且部分肌肉被切除，治疗干预有所延迟，但鉴于患者年轻，预计颈部活动范围的损害不太可能持续存在。未观察到严重不良事件，活动范围得以恢复，患者能够重新开始打棒球。静脉血栓和炎症的存在可能会影响物理治疗；然而，即使在术后早期，谨慎管理运动负荷也有助于安全有效地治疗LS，且不发生并发症。
