Descending necrotizing mediastinitis associated with Lactobacillus plantarum
BACKGROUND: Descending necrotizing mediastinitis (DNM), a severe infection with a high fatality rate, develops in mediastinal spaces due mainly to deep cervical abscesses. The majority of causative microbes of DNM are Streptococci and oral anaerobes. DNM associated with Lactobacillus-infection is ra...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847138/ https://www.ncbi.nlm.nih.gov/pubmed/23987907 http://dx.doi.org/10.1186/1471-2334-13-398 |
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author | Nei, Takahito Inai, Shunta Mikami, Iwao Sato, Akira Okamoto, Junichi Yokoshima, Kazuhiko Nakamizo, Munenaga Haraguchi, Shuji Sonobe, Kazunari Saito, Ryoichi |
author_facet | Nei, Takahito Inai, Shunta Mikami, Iwao Sato, Akira Okamoto, Junichi Yokoshima, Kazuhiko Nakamizo, Munenaga Haraguchi, Shuji Sonobe, Kazunari Saito, Ryoichi |
author_sort | Nei, Takahito |
collection | PubMed |
description | BACKGROUND: Descending necrotizing mediastinitis (DNM), a severe infection with a high fatality rate, develops in mediastinal spaces due mainly to deep cervical abscesses. The majority of causative microbes of DNM are Streptococci and oral anaerobes. DNM associated with Lactobacillus-infection is rather rare. CASE PRESENTATION: A 69-year-old male with an unremarkable past medical history was referred to our hospital for surgical resection of advanced laryngeal cancer. Full examination revealed a neck abscess and DNM with a background of untreated diabetes mellitus. Initially, he was treated with meropenem. However, Lactobacillus plantarum was isolated from surgical drainage of a mediastinal abscess. Despite using antibiotics capable of eradicating all isolates with susceptibilities not differing significantly from those of the neck and mediastinal abscesses, we attributed DNM to the L. plantarum detected only in the mediastinal abscess. After DNM treatment, he underwent total pharyngolaryngectomy with bilateral neck dissection followed by reconstruction using free jejunum. He was discharged fully recovered. CONCLUSION: We concluded that L. plantarum as the sole cause of the mediastinal abscess in the present case cannot be ruled out. As the number of immunocompromised patients increases, we should be cautious regarding this “familiar” microbe. |
format | Online Article Text |
id | pubmed-3847138 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-38471382013-12-04 Descending necrotizing mediastinitis associated with Lactobacillus plantarum Nei, Takahito Inai, Shunta Mikami, Iwao Sato, Akira Okamoto, Junichi Yokoshima, Kazuhiko Nakamizo, Munenaga Haraguchi, Shuji Sonobe, Kazunari Saito, Ryoichi BMC Infect Dis Case Report BACKGROUND: Descending necrotizing mediastinitis (DNM), a severe infection with a high fatality rate, develops in mediastinal spaces due mainly to deep cervical abscesses. The majority of causative microbes of DNM are Streptococci and oral anaerobes. DNM associated with Lactobacillus-infection is rather rare. CASE PRESENTATION: A 69-year-old male with an unremarkable past medical history was referred to our hospital for surgical resection of advanced laryngeal cancer. Full examination revealed a neck abscess and DNM with a background of untreated diabetes mellitus. Initially, he was treated with meropenem. However, Lactobacillus plantarum was isolated from surgical drainage of a mediastinal abscess. Despite using antibiotics capable of eradicating all isolates with susceptibilities not differing significantly from those of the neck and mediastinal abscesses, we attributed DNM to the L. plantarum detected only in the mediastinal abscess. After DNM treatment, he underwent total pharyngolaryngectomy with bilateral neck dissection followed by reconstruction using free jejunum. He was discharged fully recovered. CONCLUSION: We concluded that L. plantarum as the sole cause of the mediastinal abscess in the present case cannot be ruled out. As the number of immunocompromised patients increases, we should be cautious regarding this “familiar” microbe. BioMed Central 2013-08-29 /pmc/articles/PMC3847138/ /pubmed/23987907 http://dx.doi.org/10.1186/1471-2334-13-398 Text en Copyright © 2013 Nei et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Nei, Takahito Inai, Shunta Mikami, Iwao Sato, Akira Okamoto, Junichi Yokoshima, Kazuhiko Nakamizo, Munenaga Haraguchi, Shuji Sonobe, Kazunari Saito, Ryoichi Descending necrotizing mediastinitis associated with Lactobacillus plantarum |
title | Descending necrotizing mediastinitis associated with Lactobacillus plantarum |
title_full | Descending necrotizing mediastinitis associated with Lactobacillus plantarum |
title_fullStr | Descending necrotizing mediastinitis associated with Lactobacillus plantarum |
title_full_unstemmed | Descending necrotizing mediastinitis associated with Lactobacillus plantarum |
title_short | Descending necrotizing mediastinitis associated with Lactobacillus plantarum |
title_sort | descending necrotizing mediastinitis associated with lactobacillus plantarum |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847138/ https://www.ncbi.nlm.nih.gov/pubmed/23987907 http://dx.doi.org/10.1186/1471-2334-13-398 |
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