Persistent Necrotizing Mediastinitis after Dental Extraction

Figueiredo, Eugênia Leal de; Aires, Carolina Chaves Gama; Neres, Bruno José Carvalho Macêdo; Araújo, Bruna Luna de; Arruda, José Alcides Almeida de; Vasconcellos, Ricardo José de Holanda

doi:10.1155/2019/6468348

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Las principales complicaciones reportadas son: sepsis, shock séptico, síndrome de disfunción múltiple de órganos y muerte. (81,82,83,84,85)…”

Section: Complicacionesunclassified

Mediastinitis

Litardo Fernández,

López Baños,

Bajaña León

et al. 2024

Afecciones Infrecuentes en La Práctica Quirúrgica

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La mediastinitis es una afección grave, relativamente rara, peropotencialmente mortal, que implicaun proceso de inflamación y/odeinfección de los tejidos y estructuras conectivos contenidos dentro del mediastino. Puede originarseprincipalmenteporla infección profunda de la herida esternal, la perforación esofágica y la mediastinitis necrotizante descendente. Sudiagnósticose basa enelementos clínicos y hallazgos radiológicos. Resulta fundamental identificar los agentes biológicos causantespara realizar una adecuada terapia antimicrobiana. En este sentido, debe considerarse que los gérmenes responsables varían según la localización anatómica, lo cual hace queel tratamiento empírico sea desafiante. La cirugía y las medidas de apoyo deben tener como objetivo reducir el inóculo de patógenos y así proporcionarun desbridamiento y drenaje adecuado. La detección tardíade esta afección se asocia coníndices altos de morbimortalidad.

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“…Las principales complicaciones reportadas son: sepsis, shock séptico, síndrome de disfunción múltiple de órganos y muerte. (81,82,83,84,85)…”

Section: Complicacionesunclassified

Mediastinitis

Litardo Fernández,

López Baños,

Bajaña León

et al. 2024

Afecciones Infrecuentes en La Práctica Quirúrgica

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“…Based on a search of PubMed, 37 cases of PM after a dental procedure have been reported in the literature since 1973, but the real number of cases found worldwide seems to be greatly underestimated. Although treatment in most cases requires only several hours of observation and prophylactic administration of antibiotics [ 1 ], lack of knowledge about the complication after dental intervention may lead to pericarditis, sepsis, and multiple-organ failure [ 5 ]. In 2011, Romeo et al [ 6 ] reported a case in which a 25-year-old woman underwent a scheduled third-molar extraction.…”

Section: Introductionmentioning

confidence: 99%

A 39-Year-Old Woman with Cervicofacial and Mediastinal Emphysema 10 Hours After an Elective Lower Molar Dental Extraction

et al. 2021

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Patient: Female, 39-year-old Final Diagnosis: Pneumodeiastinum Symptoms: Chest discomfort • dyspnea • oedema of the face Medication: — Clinical Procedure: Antibiotics • CT scan Specialty: Critical Care Medicine Objective: Rare disease Background: Mediastinal emphysema, also called pneumomediastinum, is a very infrequent condition in patients reporting to an Emergency Department. Mediastinal emphysema is the pathologic presence of free air enclosing the mediastinal structures. In the case of chest pain in a young healthy adult, pneumomediastinum as a differential diagnosis will undoubtedly be omitted. This would be especially likely if the symptoms are not preceded by an injury, intense vomiting, or an infection in this area. Case Report: We present a case in which a previously healthy 39-year-old woman experienced painless progressive face and neck swelling, dyspnea, and retrosternal pain several hours after a dental procedure. Physical examination revealed crackles on palpation of the skin on the right part of the face, neck, and chest. Neck and chest computed tomography confirmed subcutaneous neck and upper chest emphysema and pneumomediastinum. The patient was transferred to the thoracic surgery ward. After 2 days of prophylactic intravenous administration of antibiotics, she was discharged for further scheduled treatment at the Maxillofacial Surgery Clinic. Conclusions: This report presented a rare case of a woman who reported to the Emergency Department with subcutaneous and mediastinal emphysema following routine molar dental extraction. Emergency Department physicians should be aware of the possibility of delayed complications after standard dental procedures. A detailed medical history and clinical examination will enable making a correct diagnosis so as not to jeopardize the health of a patient, and in the case of the development of mediastinitis, even the patient’s life.

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Descending Purulent Mediastinitis: Features of the Course, Diagnosis and Treatment

Sidorov

Dobrov²,

Karzakova

2022

Acta med. Eurasica

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Descending purulent mediastinitis is a rare but a life-threatening disease. The absence of characteristic symptoms and a rare incidence of descending purulent mediastinitis in clinical practice are the main reasons for the late diagnosis of this disease and high mortality due to it. In our practice, we have observed 21 cases of descending purulent mediastinitis. The aim of the study is to characterize the features of the course, methods of diagnosis and treatment for descending purulent mediastinitis used in the setting of a multidisciplinary hospital. The focus of infection was detected in 18 patients (85.7%). In most cases, the etiological factor was odontogenic infection – in the area of the second and third mandibular molars (52.3%). The results of bacterial culture test showed that streptococci (Strepto coccus viridans, β-hemolytic streptococci) and staphylococci (Staphylococcus aureus, hemolytic staphylococci) were most often plated from infected foci. In the subgroup of deceased patients, who made up 47.6% of the total number of patients, mixed cultures of microorganisms containing Staphylococcus aureus were more often detected during bacterial culture tests. These patients had to change groups of antibiotics several times. The unfavorable outcome of descending purulent mediastinitis may be due to a delay in the use of transthoracic mediastinal drainage. Early drainage of the neck and mediastinum, timely thoracotomy should be considered as the treatment method of choice in patients with descending purulent mediastinitis.

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Persistent Necrotizing Mediastinitis after Dental Extraction

Cited by 3 publications

References 11 publications

Mediastinitis

Mediastinitis

A 39-Year-Old Woman with Cervicofacial and Mediastinal Emphysema 10 Hours After an Elective Lower Molar Dental Extraction

Descending Purulent Mediastinitis: Features of the Course, Diagnosis and Treatment

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