A 58-year-old man with a history of Ludwig's angina was admitted with a spinal cord abscess at the level of C2-T1 and associated osteomyelitic destruction of vertebral bodies, spinal cord compression, and secondary quadriparesis, followed by descending mediastinitis. A right posterolateral thoracotomy and a cervicotomy drained purulent exudates. A tracheostomy was performed, and the patient was discharged after 84 days.
We report the case of a 42-year old diabetic male presenting with erythema of the neck and anterior right thoracic region secondary to the application of an ointment derived from rattlesnakes, progressing to a full-blown necrotizing fasciitis in a short period of time, with associated mediastinitis, thrombocytopaenia and sepsis. The patient died despite aggressive multidisciplinary medical and surgical treatment. We present this case due to the unusual aetiology and fulminating course.
A 22-year-old man with varicella had associated cervical enlargement, right upper thoracic anterior and suprascapular cellulitis, and mediastinitis. A tracheostomy, right posterolateral thoracotomy, cervicotomy, and upper thoracic fasciotomy were performed 14 h after admission, draining purulent exudates from all sites. The patient was discharged on postoperative day 22.
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