Descending necrotizing mediastinitis as a complication of odontogenic infection

Diamantis, S.; Giannakopoulos, Helen; Chou, Joli C.; Foote, Joseph

doi:10.1016/j.ijscr.2011.01.004

Cited by 26 publications

(27 citation statements)

References 20 publications

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“…Kocher et al and Palma et al recently described their single-center experiences with DNM that signified the complex and heterogeneous clinical manifestation of the disease resulting in varying clinical outcomes [33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Continuous venovenous hemodiafiltration using cytokine-adsorbing hemofilters as adjuvant therapy for anaerobic descending necrotizing mediastinitis: a case report

et al. 2019

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Background: We describe a combinatorial intensive care approach and discuss the critical factors that allowed us to successfully manage a life-threatening case of acute anaerobic septic shock triggered by descending necrotizing mediastinitis. Case presentation: We admitted a 38-year-old critically ill Kosovar Albanian man to our intensive care unit because of clinical manifestations of severe sepsis. His condition had worsened in the previous 2 weeks following unsuccessful antibiotic therapy for tonsillitis complicated by retropharyngeal abscesses. Computed tomography and intraoperative observations identified abscesses in the anterior and middle mediastinum regions and the distal part of the neck, directly on the border with the left lobe of the thyroid gland. Cultures indicated infections with α-hemolytic Streptococcus and Clostridium species: High procalcitonin and lactate levels, blood gas analysis, poor peripheral capillary oxygen saturation, and severe hemodynamic instability pointed to a case of acute septic shock. The entire treatment consisted of an aggressive antibiotic regimen, transthoracic and mediastinal surgical evacuation of the abscess, vacuum sealing drainage with a pleural chest tube, continuous venovenous hemodiafiltration using cytokine-adsorbing hemofilters, and extracorporeal blood hyperoxygenation. Conclusions: Efficient treatment of severe anaerobic sepsis resulting from descending necrotizing mediastinitis should build on a multidisciplinary approach. In support of first-line therapies with targeted antibiotics and surgical debridement, clinicians should consider alternative therapies such as continuous venovenous hemodiafiltration with cytokine-adsorbing hemofilters and hyperoxygenation.

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Section: Discussionmentioning

confidence: 99%

Continuous venovenous hemodiafiltration using cytokine-adsorbing hemofilters as adjuvant therapy for anaerobic descending necrotizing mediastinitis: a case report

et al. 2019

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“…In most cases of odontogenic infection involving the deep neck spaces, the submandibular space is frequently involved [16,17]. Direct spread of odontogenic infections into the submandibular space commonly arises from either the second or third mandibular molar [18][19][20], or from the sublingual space. Indirect involvement of the submandibular space commonly follows lymphatic spread.…”

Section: Discussionmentioning

confidence: 99%

A fatal case of empyema thoracis: the price for underestimating odontogenic infections

Agbara

Obiadazie

Ediagbini

et al. 2016

Oral and Maxillofacial Surgery Cases

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a b s t r a c t Most dental infections are often underestimated by both patients and professional health care givers. When poorly managed, odontogenic infections may result in serious morbidity and life-threatening conditions. This article reports a fatal case of empyema thoracis in a 16-year-old male after an odontogenic infection. The challenges of management in our environment are discussed. Furthermore, the importance of understanding the route of spread after odontogenic infections is highlighted. Ó 2015 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

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“…4,5 The most frequent pathogenic agents involved are: Streptococcus, Staphylococcus, Klebsiella, Pseudo monas aeruginosa, as well as the aerobic and anaerobic polymicrobial flora. 6 The factors favourable for such developments are mainly the associations of comorbidities: diabetes, chronic renal insufficiency, liver failure, HIV, autoimmune diseases, radio/chemotherapy antecedents, chronic alcoholism, consumption of injectable drugs. There are studies demonstrating that the presence of the diabetes increases the risk of complications, e.g.…”

Section: Introductionmentioning

confidence: 99%

Deep neck space infection – diagnostic and therapeutic challenges: two case reports

MOŞOIU¹,

MUSTEATA²,

Grigore³

et al. 2019

Arch Balk Med Union

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Infections profondes de l'espace cervical-défis diagnostiques et thérapeutiques Introduction. Les infections des espaces plus profonds du cou sont souvent un défi clinique, en tant qu'urgences médico-chirurgicales à un mauvais pronostic et un potentiel mortel dans l'absence d'un diagnostic précoce et bien appliqué. Rapport du cas 1. Le premier cas présenté est celui d'une femme de 72 ans atteinte d'anémie due au syndrome myélodysplasique, admise au service d'hématologie. Les symptômes étaient une dysphagie avec odynophagie et une tuméfaction sous-maxillaire droite, sur un fond apyrétique. Dans ce cas, l'infection a commencé par un abcès péri-amygdalien qui s'est ensuite développé en un abcès para-pharyngé. Les principales difficultés médicales sont apparues après la chirurgie, l'état général du patient s'aggravant malgré l'évolution favorable de la plaie chirurgicale. Une récupération totale, y compris la déglutition, était possible deux mois après avoir quitte l'hôpital. Rapport du cas 2. La deuxième patiente est une jeune femme de 26 ans avec un bon statut social et matériel, sans comorbidités associées.

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Descending necrotizing mediastinitis as a complication of odontogenic infection

Cited by 26 publications

References 20 publications

Continuous venovenous hemodiafiltration using cytokine-adsorbing hemofilters as adjuvant therapy for anaerobic descending necrotizing mediastinitis: a case report

Continuous venovenous hemodiafiltration using cytokine-adsorbing hemofilters as adjuvant therapy for anaerobic descending necrotizing mediastinitis: a case report

A fatal case of empyema thoracis: the price for underestimating odontogenic infections

Deep neck space infection – diagnostic and therapeutic challenges: two case reports

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