Descending necrotizing mediastinitis: a case report and review of the literature

Descending necrotizing mediastinitis: a case report and review of the literature

Descending necrotizing mediastinitis (DNM) is a highly fatal disease and as infection spreads along deep cervical planes into the mediastinum, widespread cellulitis, necrosis, abscess formation, and sepsis may occur. Early diagnosis is crucial for starting aggressive treatment without delay. Cervico...

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Bibliographic Details
Published in:International surgery Vol. 86; no. 1; p. 62
Main Authors: Balkan, M E, Oktar, G L, Oktar, M A
Format: Journal Article
Language:English
Published: Italy 01-01-2001
Subjects:
Adult
Diagnosis, Differential
Fatal Outcome
Female
Humans
Mediastinitis - diagnosis
Mediastinitis - microbiology
Mediastinitis - therapy
Necrosis
Tomography, X-Ray Computed
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Summary:Descending necrotizing mediastinitis (DNM) is a highly fatal disease and as infection spreads along deep cervical planes into the mediastinum, widespread cellulitis, necrosis, abscess formation, and sepsis may occur. Early diagnosis is crucial for starting aggressive treatment without delay. Cervicothoracic computed tomography (CT) scanning may be useful for early diagnosis and preoperative evaluation of the surgical approach. Optimal treatment includes broad-spectrum antimicrobial therapy and extensive cervicomediastinal and transthoracic drainage. Clamshell incision provides an excellent exposure of both thoracic cavities and all mediastinal structures with minimal morbidity. We report here a fatal case of DNM with bilateral empyema and purulent pericarditis due to an odontogenic abscess with a brief review of the literature.
ISSN:0020-8868