Mediastinitis Necrotizante Descendente Secundaria a Infección Periodontal con Extensión a Pleura y Peritoneo. Reporte de un Caso y Revisión

Rangel, Juan Carlos Villanueva; Martínez, Arnulfo Bravo; Vimbela, Lizette Segura; Crespo, Erika Villalobos; Jiménez, Juan José Almazán

doi:10.5413/mrmc.2009.61.116

Cited by 3 publications

(4 citation statements)

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“…We cannot rule out the possibility that the bacteraemia was also influential in the implantation and future abscessification of isolated septic foci, although their connection with a descending nature and the history of an odontogenic abscess support the theory of a false initial cure of the cervical abscess and its subsequent spread to lower planes, rather than the bacteraemia causing abscesses above the original focus. Other authors have already described the passage of pus to the abdomen by descending continuity (4,8), which argues in favour of this rare but possible, and in this case exceptional, event. Thus, treatment of severe abscessed OI should be based on CT-controlled diagnosis and follow-up (4), and should combine intravenous broad-spectrum antibiotics together with surgical drainage of the purulent collections (4,9).…”

Section: Discussionmentioning

confidence: 95%

“…There are three potential routes descending from the neck to the mediastinum by which an OI may progress: the retropharyngeal / retroesophageal route, which is the most important; and the perivascular and the pretracheal routes (4). The few reports of an OI with an abdominal component are normally related with bacteraemia from dental foci, and include liver (5), suprarenal (6) and retroperitoneal (7) abscesses, and occasionally abscesses due to continuity via the diaphragm following anatomical planes (4,8). We present a case of vulvar-perineal abscess forming part of a network of abdominal, thoracic and cervical collections of pus that followed a downward course from a dental focus.…”

Section: Introductionmentioning

confidence: 99%

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Multiple odontogenic abscesses. Thoracic and abdomino-perineal extention in an immuno competent patient

et al. 2011

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Introduction: Odontogenic infection (OI) may lead to death if it extends beyond the buccal area. The virulence of pathogens and the local and systemic status of the patient influence the propagation of the pathogen, either by anatomical continuity or haemematogenous dissemination. Several severe complications derived from OI have been reported in the head, neck and chest. However, OI with an abdominal component, caused by bacteraemia with dental foci or the direct passage of pus from the thorax to the abdomen, are unusual. Case report: We present the case of a young immunocompetent woman who, after false cure of an odontogenic abscess, again reported gynaecological symptoms. A network of connected abdomino-perineal, thoracic and cervical abscesses was discovered. Discussion: The peculiarity and severity of this case is a reminder that treatment of an abscessed OI should include intravenous broad-spectrum antibiotics, together with surgical drainage of the purulent collections. Samples should be taken for culture and an antibiogram in order to use specific antibiotics if the initial empirical therapy shows resistance. The diagnosis and follow-up should be by CT, which in our patient showed anatomical continuity of the abscesses from the dental focus. The time sequence of the symptoms, in the absence of any other infectious cause, revealed the descending odontogenic nature of the process.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Multiple odontogenic abscesses. Thoracic and abdomino-perineal extention in an immuno competent patient

et al. 2011

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“…The global literature reports several cases of mediastinal dissemination of deep cervical abscess [7–10]. Although rare, there are some cases of hepatic abscess through hematogenic dissemination [11–13]; however, abdominal dissemination by contiguity is even rarer, and it occurred in only one case of retroperitoneal localization [14] and another with abdominoperineal extension [15].…”

Section: Discussionmentioning

confidence: 99%

“…However, abdominal dissemination by contiguity (such as the case we report herein) is much rarer. It occurred in one case of retroperitoneal localization [14] and another one with abdominoperineal extension [15].…”

Section: Introductionmentioning

confidence: 99%

Subphrenic abscess secondary to cervical abscess and fasciitis from dental focus: case report

et al. 2019

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Background Cervical fasciitis is a group of severe infections with high morbimortality. Reports in the literature of patients with cases evolving with mediastinal dissemination of deep cervical abscess are common. However, cases of abdominal dissemination by contiguity are much rarer. Case presentation A 34-year-old Caucasian man presented to the emergency department with a 15-day history of left neck edema, local pain, and fever. Seventeen days prior to presentation, he had undergone odontogenic surgical treatment in a dental clinic. Laboratory examinations did not show meaningful changes. He underwent computed tomography of the neck, thorax, and abdomen, which showed evidence of left collection affecting the retromandibular, submandibular, parapharyngeal, vascular, and mediastinal spaces, bilateral pleural effusion, right subphrenic collection and a small amount of liquids between intestinal loops. A cervical, thoracic, and abdominal surgical approach at the same surgery was indicated for odontogenic cervical abscess, descending necrotizing mediastinitis, and subphrenic abscess. The patient remained in the intensive care unit for three days, and he was discharged on the 22nd day after surgery with no drains and no tracheostomy. His outpatient discharge occurred after 6 months with no sequelae. Conclusions Aggressive surgical treatment associated with antibiotic therapy has been shown to be effective for improving the clinical course of cervical fasciitis. Despite the extension of the infection in our patient, a surgical approach of all infectious focus associated with a broad-spectrum antibiotic therapy led to a good clinical evolution and has significant implications for aggressive treatment.

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Stenotrophomonas maltophilia: Descripción de un agente altamente infeccioso

Hernández

Calleros

Muñoz

2020

Acta otorrinolaringol cir cabeza cuello

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Stenotrophomonas maltophilia es una bacteria oportunista que causa diversos tipos de infecciones asociadas a la atención sanitaria en pacientes debilitados, especialmente en aquellos que previamente han recibido antimicrobianos de amplio espectro. Stenotrophomonas maltophilia se posiciona hoy en día como un patógeno nosocomial de ámbito general, añadiéndose a otros multirresistentes como Staphylococcus aureus, Acinetobacter spp. y Pseudomonas aeruginosa. Presentamos este caso dado que es el primero que encontramos en nuestro servicio, simulando una infección recurrente por micobacterias, con el objetivo de demostrar el protocolo utilizado para diagnóstico y tratamiento; Este germen es poco frecuentemente reportado, siendo todos en inmunosuprimidos o con tratamiento antibiótico prolongado. Este agente infeccioso debe considerarse e incluirse entre los diagnósticos diferenciales de conglomerados ganglionares abscedados. En pacientes con inmunosupresión sospechada o conocida es necesario descartar la presencia de microorganismos oportunistas, para poder proveerle un adecuado diagnóstico y tratamiento específico

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Mediastinitis Necrotizante Descendente Secundaria a Infección Periodontal con Extensión a Pleura y Peritoneo. Reporte de un Caso y Revisión

Cited by 3 publications

References 0 publications

Multiple odontogenic abscesses. Thoracic and abdomino-perineal extention in an immuno competent patient

Multiple odontogenic abscesses. Thoracic and abdomino-perineal extention in an immuno competent patient

Subphrenic abscess secondary to cervical abscess and fasciitis from dental focus: case report

Stenotrophomonas maltophilia: Descripción de un agente altamente infeccioso

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