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descending necrotizing mediastinitis

Dong Wei, Ling Bi, Huiyong Zhu, Jianfeng He, Huiming Wang
By a 7-year retrospective review, we reported our experience in management of descending necrotizing mediastinitis (DNM) and deep neck infection (DNI). A retrospective design was used to reveal the clinical characteristics of DNI and DNM. The clinical outcome was analyzed to validate less invasive management. We reviewed 82 patients between 2009 and 2016, 12 of which were diagnosed as DNM by clinical and computed tomography findings. A total of 35 patients had relevant systemic conditions, mainly diabetes mellitus (19 patients)...
April 2017: Medicine (Baltimore)
Takao Minakata, Yumiko Niiya, Yutaka Oshima, Naoya Himuro, Yuri Tomita, Daisuke Kataoka, Noboru Tanio, Shigeru Yamamoto, Takashi Suzuki, Mitsutaka Kadokura
The patient, a 65-year-old woman, visited at her local doctor's office with the chief complaint of pharyngeal pain. After being administered antibacterial drugs, hyperthermia persisted and the pharyngeal pain became exacerbated. She was referred to our hospital and diagnosed as a retropharyngeal abscess and descending necrotizing mediastinitis (DNM). She was urgently hospitalized and surgery was performed. The mediastinal pleura was incised with thoracoscopic guidance and curettage, irrigation, and drainage were performed...
March 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Taisuke Kaiho, Takahiro Nakajima, Shuji Yonekura, Sawako Hamasaki, Takekazu Iwata, Ichiro Yoshino
Descending necrotizing mediastinitis is a severe infection of the mediastinum. Lemierre's syndrome manifests as thrombophlebitis in the cervical veins, which is caused by a neck infection. A 50-year-old woman had a fever with a 13-day history of neck pain. CT showed a deep neck abscess with vertebral vein thrombosis and mediastinal abscesses. Multiple small pulmonary nodules were found, suggesting septic pulmonary embolism. Emergency surgery for bilateral cervical and mediastinal drainage was performed, and antibiotics and anticoagulation agent was administered...
February 1, 2017: General Thoracic and Cardiovascular Surgery
Yasir Abu-Omar, Gregor J Kocher, Paolo Bosco, Cristina Barbero, David Waller, Tomas Gudbjartsson, Miguel Sousa-Uva, Peter B Licht, Joel Dunning, Ralph A Schmid, Giuseppe Cardillo
Mediastinitis continues to be an important and life-threatening complication after median sternotomy despite advances in prevention and treatment strategies, with an incidence of 0.25-5%. It can also occur as extension of infection from adjacent structures such as the oesophagus, airways and lungs, or as descending necrotizing infection from the head and neck. In addition, there is a chronic form of 'chronic fibrosing mediastinitis' usually caused by granulomatous infections. In this expert consensus, the evidence for strategies for treatment and prevention of mediatinitis is reviewed in detail aiming at reducing the incidence and optimizing the management of this serious condition...
January 2017: European Journal of Cardio-thoracic Surgery
Yusuke Takanashi, Takamitsu Hayakawa, Hiroshi Neyatani, Kazuhito Funai
Descending necrotizing mediastinitis (DNM) is a potentially lethal disease that originates from a deep neck infection (DNI); it is often associated with an immunocompromised state. Hyperimmunoglobulin E syndrome (HIES) is an extremely rare complex immune deficiency characterized by recurrent abscesses of staphylococcal etiology. A rare case of a 34-year-old woman wherein HIES putatively promoted the development of DNI into DNM is described. She presented with cervical purulent lymphadenitis and retropharyngeal abscess...
July 2016: Respirology Case Reports
Luis Gorospe Sarasúa, Ana Paz Valdebenito-Montecino, Gemma María Muñoz-Molina
No abstract text is available yet for this article.
June 30, 2016: Archivos de Bronconeumología
Elvira Ventura Spagnolo, Cristina Mondello, Luigi Cardia, Orazio Ventura Spagnolo, Giovanni Bartoloni
No abstract text is available yet for this article.
December 2016: Minerva Stomatologica
J Kluge
BACKGROUND: A systematic approach to the etiology and possible course of acute mediastinitis is a prerequisite for adequate diagnostics and therapy. Chronic mediastinitis represents a rarity in the clinical practice. MATERIAL AND METHOD: A selective literature search was carried out. RESULTS: An acute infection of the mediastinum occurs after perforation of mediastinal structures, such as the esophagus and trachea mostly of iatrogenic origin and as descending necrotizing mediastinitis (DNM) from oropharyngeal foci...
June 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Marijan Kovacić, Ivan Kovacić, Boris Dželalija
Descending necrotizing mediastinitis secondary to a nontraumatic retropharyngeal abscess is very rare. This form of mediastinitis in the era of potent antibiotics often ends up with lethal outcome. It usually occurs in immunocompromised patients and requires intensive multidisciplinary treatment approach. We report a case of nontraumatic retropharyngeal abscess complicated by descending necrotizing mediastinitis in a 70-year-old man with insulin dependent diabetes mellitus. The patient was admitted to our hospital after clinical and radiological diagnosis of retropharyngeal abscess...
December 2015: Acta Clinica Croatica
Y T Liew, Elizabeth Yenn Lynn Lim, A B Zulkiflee, N Prepageran
Descending necrotizing mediastinitis (DNM) is a rapidly progressive disease from the spread of cervical infection. Transcervical and transthoracic drainage was the recognized traditional surgical approach to achieve adequate clearance of infection. Non-invasive vacuum-assisted dressing is a new technique where applied negative pressure can help remove infective fluid and to promote wound healing. A 60-year-old man presented with odynophagia, fever and anterior neck swelling for 2 weeks. He was diagnosed to have anterior neck abscess and underwent surgical drainage...
April 2017: General Thoracic and Cardiovascular Surgery
Andrew Botha, Fred Jacobs, Corne Postma
INTRODUCTION: Ludwig's angina (LA) still presents regularly at our tertiary academic hospital. Various etiologies and comorbid diseases are documented worldwide, but the South African population has not been studied. AIM: To establish whether LA cases presenting to the department are different from international reports regarding etiology and comorbidities. SETTINGS AND DESIGN: Retrospective analysis of patients presenting with LA to a tertiary hospital...
July 2015: Annals of Maxillofacial Surgery
Héctor M Prado-Calleros, Edgardo Jiménez-Fuentes, Irma Jiménez-Escobar
BACKGROUND: Descending necrotizing mediastinitis is a serious infection involving the neck and the chest, in which an odontogenic, pharyngeal, or cervical infection spreads rapidly to the thoracic cavity, with a high death rate by sepsis and organic failure if not treated quickly and properly. METHODS: A systematic search in the electronic database PubMed was conducted using the keywords "mediastinitis" and "descending necrotizing mediastinitis" resulting in 2560 items, filters were activated (systematic review, meta-analysis, and clinical trial) resulting in 60 articles, from which we selected relevant articles on the topic...
April 2016: Head & Neck
B M Buchholz, A Kania, M Kaminski
BACKGROUND: Descending necrotizing mediastinitis (DNM) originates from odontogenic or oropharyngeal infections which spread along preformed cervicothoracic spaces into the mediastinum and requires emergency multidisciplinary treatment. MATERIAL AND METHODS: A total of seven patients were diagnosed with DNM based on typical radiological features in a cervicothoracic computed tomography (CT) scan and subsequently underwent standardized transcervical and open transthoracic radical debridement...
July 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
I-Chen Chen, Jong-Hau Hsu, Zen-Kong Dai
Descending necrotizing mediastinitis (DNM) is an uncommon disease that can cause significant morbidity and mortality. Herein, we report a 17-month-old girl of DNM with an initial normal chest radiograph followed by rapid clinical deterioration during a period of 4 days, from deep neck infection to mediastinitis and then complicated empyema. She was managed successfully with intravenous antibiotics and surgical debridement by video-assisted thoracic surgery (VATS) and cervical drainage. Early recognition and meticulous intensive care of patients with DNM are important to minimize morbidity and mortality...
May 2016: Pediatric Pulmonology
Minoru Fukuchi, Okihide Suzuki, Daisuke Nasu, Kazue Koizumi, Yu Muta, Hideko Imaizumi, Toru Ishiguro, Youichi Kumagai, Keiichiro Ishibashi, Erito Mochiki, Hideyuki Ishida
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...
September 2015: Case Reports in Gastroenterology
Vivek Chauhan, Surinder Thakur
No abstract text is available yet for this article.
July 2015: International Journal of Critical Illness and Injury Science
Daniela M Palma, Simone Giuliano, Andrea N Cracchiolo, Marco Falcone, Giancarlo Ceccarelli, Romano Tetamo, Mario Venditti
PURPOSE: We aimed to investigate clinical features of patients with descending necrotizing mediastinitis (DNM) in order to improve management and outcome. METHODS: We prospectively examined all patients with DNM admitted to the Intensive Care Unit (ICU) during the period from April 2007 to December 2013. Demographics, clinical features, microbiology, medical and surgical treatment data were recorded. Survivor and nonsurvivor groups were analyzed to identify factors associated with mortality...
February 2016: Infection
Hayato Konno, Yoshihiro Minamiya
Acute mediastinitis is an infectious disease of differentiated etiology, characterized by a rapid and severe course. Causes, diagnosis, and treatment of acute mediastinitis was described. Our experience of descending necrotizing mediastinitis were demonstrated with chest X-ray, computed tomography (CT), and operative findings. Recognition, prompt diagnosis, and early treatment of the disease were emphasized.
July 2015: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Muhammed Sedat Sakat, Enver Altaş, Bülent Aktan, Korhan Kiliç, Harun Üçüncü
No abstract text is available yet for this article.
July 2015: Journal of Craniofacial Surgery
Taryn Lloyd, Vu Kiet Tran
Acute mediastinitis is a rare, potentially life-threatening condition that is most commonly seen as a complication of esophageal perforations or cardiac surgery. The term "descending necrotizing mediastinitis" (DNM) is used to describe oropharyngeal infections that spread to the mediastinum, most commonly following odontogenic infections, peritonsillar or retropharyngeal abscesses, cervical lymphadenitis, trauma, or endotracheal intubation. Infectious mononucleosis is another rare cause of DNM. The mortality of acute mediastinitis is high, while the mortality for DNM is even higher...
March 2016: CJEM
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