Descending necrotizing mediastinitis associated with spinal cord abscess

Abstract

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.

Systematic review of spontaneous pneumomediastinum: A survey of 22 years’ data

“…Thoracic surgeons in particular should always remember that pneumomediastinum could be present in not so benign entities such as mediastinitis, after endoscopic procedures, and in trauma patients among others. [31][32][33] Therefore, it is of the outmost importance for the physician to recognize pertinent clinical data in order to stop a potential catastrophe when gas is encountered in the mediastinal spaces, and to choose the optimal management between dynamic observation and a life-saving surgical procedure.…”

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.…”