Descending necrotizing mediastinitis and thoracic cellulitis due to varicella

Abstract

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.

Descending necrotizing mediastinitis below the tracheal carina

“…Historically, the main sources of DNM have been described as odontogenic, peritonsillar or other retropharyngeal infections, but various etiologies have been described by our group and others. [4][5][6][7] Surgical treatment includes transcervical, transthoracic, or mixed approaches. 8,9 Recently, video-assisted thoracoscopic surgery has gained acceptance among thoracic surgeons.…”

Descending necrotizing mediastinitis and sternoclavicular joint osteomyelitis

“…The most frequent etiology of nonsurgical mediastinitis is odontogenic abscesses, followed by deep cervical involvement and descent into the mediastinum; other rare etiologies have been reported. 1,2 Sternoclavicular joint osteomyelitis culminating in full-blown mediastinitis has been reported only once as the etiology of this dreadful disease. 3 We describe a case of this association and underscore its favorable course during a lengthy hospital stay.…”