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Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage

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 tre...

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Autores principales: Fukuchi, Minoru, Suzuki, Okihide, Nasu, Daisuke, Koizumi, Kazue, Muta, Yu, Imaizumi, Hideko, Ishiguro, Toru, Kumagai, Youichi, Ishibashi, Keiichiro, Mochiki, Erito, Ishida, Hideyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4649729/
https://www.ncbi.nlm.nih.gov/pubmed/26600767
http://dx.doi.org/10.1159/000441386
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author Fukuchi, Minoru
Suzuki, Okihide
Nasu, Daisuke
Koizumi, Kazue
Muta, Yu
Imaizumi, Hideko
Ishiguro, Toru
Kumagai, Youichi
Ishibashi, Keiichiro
Mochiki, Erito
Ishida, Hideyuki
author_facet Fukuchi, Minoru
Suzuki, Okihide
Nasu, Daisuke
Koizumi, Kazue
Muta, Yu
Imaizumi, Hideko
Ishiguro, Toru
Kumagai, Youichi
Ishibashi, Keiichiro
Mochiki, Erito
Ishida, Hideyuki
author_sort Fukuchi, Minoru
collection PubMed
description 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. We performed mediastinal drainage via right thoracotomy. Cervicotomy was performed on postoperative day 14 to drain a residual cervical abscess. The patient required the extraction of ten teeth over three procedures to address primary odontogenic infection before his fever resolved on postoperative day 40. Prompt diagnosis, aggressive drainage and removal of the source of infection can improve survival among patients with this life-threatening disease.
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spelling pubmed-46497292015-11-23 Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage Fukuchi, Minoru Suzuki, Okihide Nasu, Daisuke Koizumi, Kazue Muta, Yu Imaizumi, Hideko Ishiguro, Toru Kumagai, Youichi Ishibashi, Keiichiro Mochiki, Erito Ishida, Hideyuki Case Rep Gastroenterol Published online: October 2015 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. We performed mediastinal drainage via right thoracotomy. Cervicotomy was performed on postoperative day 14 to drain a residual cervical abscess. The patient required the extraction of ten teeth over three procedures to address primary odontogenic infection before his fever resolved on postoperative day 40. Prompt diagnosis, aggressive drainage and removal of the source of infection can improve survival among patients with this life-threatening disease. S. Karger AG 2015-10-13 /pmc/articles/PMC4649729/ /pubmed/26600767 http://dx.doi.org/10.1159/000441386 Text en Copyright © 2015 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Published online: October 2015
Fukuchi, Minoru
Suzuki, Okihide
Nasu, Daisuke
Koizumi, Kazue
Muta, Yu
Imaizumi, Hideko
Ishiguro, Toru
Kumagai, Youichi
Ishibashi, Keiichiro
Mochiki, Erito
Ishida, Hideyuki
Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage
title Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage
title_full Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage
title_fullStr Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage
title_full_unstemmed Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage
title_short Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage
title_sort descending necrotizing mediastinitis treated with tooth extractions following mediastinal and cervical drainage
topic Published online: October 2015
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4649729/
https://www.ncbi.nlm.nih.gov/pubmed/26600767
http://dx.doi.org/10.1159/000441386
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