Tzu Chi Medical Journal
Volume 21, Issue 4 , Pages 348-351, December 2009

Rare Type of Deep Neck Infection: Two Cases of Descending Necrotizing Mediastinitis

  • Shih-Ming Huang

      Affiliations

    • Department of Emergency Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
    • ,
  • Ren-Chieh Wu

      Affiliations

    • Department of Emergency Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
    • School of Medicine, Tzu Chi University, Hualien, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Emergency Medicine, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien, Taiwan

Received 6 October 2008; received in revised form 28 October 2008; accepted 11 November 2008.

Article Outline

Abstract 

Descending necrotizing mediastinitis is a relatively uncommon complication of deep neck infections. Patients often have some type of immuno-compromised condition. Computed tomography is very helpful for early diagnosis. Poor prognosis is due to delays in diagnosis or inappropriate surgical drainage. We present two cases of descending necrotizing mediastinitis that was successfully treated because of early diagnosis and adequate surgical intervention.

Keywords:  Deep neck infection , Mediastinitis , Necrotizing fasciitis

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Freeman RK , Vallieres E , Verrier ED , Karmy-Jones R , Wood DE . Descending necrotizing mediastinitis: an analysis of the effects of serial surgical debridement on patient mortality . J Thorac Cardiovasc Surg . 2000;119:260–267
  2. Pearse HE . Mediastinitis following cervical suppuration . Ann Surg . 1938;107:588–611
  3. Roccia F , Pecorari GC , Oliaro A , et al.   Ten years of descending necrotizing mediastinitis: management of 23 cases . J Oral Maxillofac Surg . 2007;65:1716–1724
  4. Pinto A , Scaglione M , Scuderi MG , Tortora G , Daniele S , Romano L . Infection of the neck leading to descending necrotizing mediastinitis: role of multi-detector row computed tomography . Eur J Radiol . 2008;65:389–394
  5. Brook I . Antibiotic resistance of oral anaerobic bacteria and their effect on the management of upper respiratory tract and head and neck infections . Semin Respir Infect . 2002;17:195–203
  6. Yellon RF . Head and neck space infections . In:  Bluestone CD ,  Casselbrant ML ,  Stool SE editor. 4th edition. Pediatric Otolaryngology . Volume 2: Philadelphia: Saunders; 2003;p. 1681–1701
  7. Endo S , Murayama F , Hasegawa T , et al.   Guidelines for surgical management based on the diffusion of descending necrotizing mediastinitis . Jpn J Thorac Cardiovasc Surg . 1999;47:14–19
  8. Makeieff M , Gresillon N , Berthet JP , et al.   Management of descending necrotizing mediastinitis . Laryngoscope . 2004;114:772–775
  9. Novellas S , Kechabtia K , Chevallier P , Sedat J , Bruneton JN . Descending necrotizing mediastinitis: a rare pathology to keep in mind . Clin Imaging . 2005;29:138–140
  10. Endo S , Tsubochi H , Nakano T , Sohara Y . Descending necrotizing mediastinitis secondary to retropharyngeal abscess without cervical spread . Gen Thorac Cardiovasc Surg . 2008;56:25–27
  11. Chen KC , Chen JS , Kuo SW , et al.   Descending necrotizing mediastinitis: a 10-year surgical experience in a single institution . J Thorac Cardiovasc Surg . 2008;136:191–198

PII: S1016-3190(09)60070-7

doi:10.1016/S1016-3190(09)60070-7

Tzu Chi Medical Journal
Volume 21, Issue 4 , Pages 348-351, December 2009

Article Tools