Descendant necrotizing mediastinitis developed following an odontogenic infection (case report) Bir odontojenik enfeksiyon sonrasi gelişen desendan nekrotizan mediyastinit
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi, cilt.14, sa.2, ss.70-75, 2008 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 14 Sayı: 2
- Basım Tarihi: 2008
- Dergi Adı: Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.70-75
- Anahtar Kelimeler: Descending necrotizing mediastinitis, Intensive care unit (ICU), Mediastinal drainage
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Descendant necrotizing mediastinitis (DNM) is a rare pathology occurring with high mortality rates (50 %) as a result of the expansion of infections related to the bases of mouth and cervix through anatomic cavities and it generally necessitates urgent therapy. Early diagnosis is difficult as the symptoms are not specific. The treatment method to be applied on the patients with DNM may be either surgical drainage or thoracotomy. The patient at the age of 21 who is suspected with deep cervical infection and cervical abcess developed as a result of the 5th molar tooth extraction from left upper chin 10 days ago was applied abcess drainage in ENT department and then he was transferred to the intensive, care unit as intubated with the diagnosis of sepsis. No progress was observed in the patient during his intensive care. 6 days later he was diagnosed with DNM according to the findings of posterior-anterior (PA) chest x-ray and bridn-cervix-thorax computerized tomography (CT). During his treatment in addition to the cervical abcess drainage, he was applied right thoracotomy and anterior cervical mediastinotomy followed by appropriate antibiotherapy. On the 26th day of the patient in hospital he was transferred to the ENT department from the intensive care unit because of the problems such as existence, of tracheostomy, open cervical incision line, left facial paralysis and left horner's syndrome. The patient who had no longer complaints was discharged from hospital on the 56th day of his presence there. The patients with simple pharyngeal or odontogenic infections should be suspected with DNM diagnosis when their general conditions are observed to worsen. In conclusion, DNM is a life-threatening pathology and early diagnosis, appropriate antibiotic therapy and efjective mediastinal drainage are the musts for a good prognosis.