Descending necrotizing mediastinitis caused by an odontogenic infection: A case report

Tsunoda, Reiko; Suda, Satoshi; Fukaya, Takashi; Saitô, Kenichi

doi:10.1016/s0278-2391(00)90348-3

Cited by 16 publications

(8 citation statements)

References 12 publications

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“…Besides, CT is beneficial in postoperative follow-up of DNM. 1,6,[9][10][11][12] The fact is that a delay in diagnosis of several days results in severe complications such as pyothorax, aortopulmonal fistula, sepsis, the erosion of the carotid artery or aorta, purulent pericarditis, DIC and multiple damages to the organs. 13 Our patient developed bilateral pleural empyema which is infrequently described as a complication of odontogenic DNM.…”

Section: Discussionmentioning

confidence: 99%

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Mediastinitis and bilateral pleural empyema caused by an odontogenic infection

Juretić¹,

Belušić-Gobić²,

Kukuljan³

et al. 2007

Radiology and Oncology

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Background. Although odontogenic infections are relatively frequent in the general population, intrathoracic dissemination is a rare complication. Acute purulent mediastinitis, known as descending necrotizing mediastinitis (DNM), causes high mortality rate, even up to 40%, despite high efficacy of antibiotic therapy and surgical interventions. In rare cases, unilateral or bilateral pleural empyema develops as a complication of DNM. Case report. This case report presents the treatment of a young, previously healthy patient with mediastinitis and bilateral pleural empyema caused by an odontogenic infection. After a neck and pharynx re-incision, and as CT confirmed propagation of the abscess to the thorax, thoracotomy was performed followed by CT-controlled thoracic drainage with continued antibiotic therapy. The patient was cured, although the recognition of these complications was relatively delayed. Conclusions. Early diagnosis of DNM can save the patient, so if this severe complication is suspected, thoracic CT should be performed.

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Section: Discussionmentioning

confidence: 99%

“…Nevertheless, in case of a massive infection transthoracic approach is required. 1,6,8,10,12,13,19 Posterolateral thoracotomy provides adequate drainage of all portions of the mediastinum, pleural cavity and pericardium. One of the issues is also to perform tracheostomy immediately or to leave a tracheal tube.…”

Section: Discussionmentioning

confidence: 99%

Mediastinitis and bilateral pleural empyema caused by an odontogenic infection

Juretić¹,

Belušić-Gobić²,

Kukuljan³

et al. 2007

Radiology and Oncology

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“…DNM occurring as a complication of an oropharyngeal infection has been previously described in the literature (Bartsch et al, 2005;Hendler and Quinn, 1978;Sakamoto et al, 2000;Reed and Anand, 1992;Tsunoda et al, 2000). This entity has been less frequently reported occurring after an asymptomatic dental extraction (Wheatley et al, 1990;Ely et al, 1993;Malis et al, 2008).…”

Section: Introductionmentioning

confidence: 90%

Descending necrotizing mediastinitis following dental extraction. Radiological features and surgical treatment considerations

González-García

Risco-Rojas

Román-Romero

et al. 2011

Journal of Cranio-Maxillofacial Surgery

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“…This life-threatening condition is often misdiagnosed in its early stages because of its rarity and non-specific symptoms. Computed tomography (CT) is an invaluable tool in the diagnosis of DNM, both in the initial detection of infection and in monitoring the response to treatment [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage

Fukuchi

Suzuki

Nasu

et al. 2015

Case Rep Gastroenterol

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Descending necrotizing mediastinitis (DNM) is a rare condition in which oropharyngeal infection spreads to the mediastinum via the cervical fascia. Delayed diagnosis and surgery result in a high mortality rate among patients with DNM. We present a case of DNM resulting from odontogenic infection treated successfully with tooth extraction following mediastinal and cervical drainage. A 43-year-old, previously healthy Japanese man was admitted to our hospital for treatment of acute mediastinitis. Computed tomography revealed gas collection around the mid-thoracic esophagus and bilateral pleural effusion. We performed mediastinal drainage via right thoracotomy. Cervicotomy was performed on postoperative day 14 to drain a residual cervical abscess. The patient required the extraction of ten teeth over three procedures to address primary odontogenic infection before his fever resolved on postoperative day 40. Prompt diagnosis, aggressive drainage and removal of the source of infection can improve survival among patients with this life-threatening disease.

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Descending necrotizing mediastinitis caused by an odontogenic infection: A case report

Cited by 16 publications

References 12 publications

Mediastinitis and bilateral pleural empyema caused by an odontogenic infection

Mediastinitis and bilateral pleural empyema caused by an odontogenic infection

Descending necrotizing mediastinitis following dental extraction. Radiological features and surgical treatment considerations

Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage

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