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Fukuchi M, Suzuki O, Nasu D, Koizumi K, Muta Y, Imaizumi H, Ishiguro T, Kumagai Y, Ishibashi K, Mochiki E, Ishida H. Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage. Case Rep Gastroenterol 2015; 9:311-6. [PMID: 26600767 PMCID: PMC4649729 DOI: 10.1159/000441386] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
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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Affiliation(s)
- Minoru Fukuchi
- Department of Digestive Tract and General Surgery, Saitama Medical University, Kawagoe, Japan
| | - Okihide Suzuki
- Department of Digestive Tract and General Surgery, Saitama Medical University, Kawagoe, Japan
| | - Daisuke Nasu
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Kazue Koizumi
- Department of Digestive Tract and General Surgery, Saitama Medical University, Kawagoe, Japan
| | - Yu Muta
- Department of Digestive Tract and General Surgery, Saitama Medical University, Kawagoe, Japan
| | - Hideko Imaizumi
- Department of Digestive Tract and General Surgery, Saitama Medical University, Kawagoe, Japan
| | - Toru Ishiguro
- Department of Digestive Tract and General Surgery, Saitama Medical University, Kawagoe, Japan
| | - Youichi Kumagai
- Department of Digestive Tract and General Surgery, Saitama Medical University, Kawagoe, Japan
| | - Keiichiro Ishibashi
- Department of Digestive Tract and General Surgery, Saitama Medical University, Kawagoe, Japan
| | - Erito Mochiki
- Department of Digestive Tract and General Surgery, Saitama Medical University, Kawagoe, Japan
| | - Hideyuki Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical University, Kawagoe, Japan
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Yilmaz S, Bas B, Ozden B, Selcuk U, Cengel Kurnaz S. Deep neck infection after third molar extraction. J Istanb Univ Fac Dent 2015; 49:41-45. [PMID: 28955535 PMCID: PMC5573484 DOI: 10.17096/jiufd.82633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 12/02/2014] [Indexed: 11/25/2022] Open
Abstract
Odontogenic and oropharyngeal infections are
relatively common in the cervicofacial region. In rare
cases, odontogenic or peritonsillar abscesses may
spread through the deep fascial cervical spaces and
cause life-threatening complications. Odontogenic
infection is the most common cause of deep neck
infections and it accounts for 43% of the cases.
Early diagnosis, immediate antibiotic treatment, and
surgical drainage are the basis of therapeutic success.
Deep neck infections are potentially life threatening
complications if they are not diagnosed in time and
treated quickly. This case report presents clinical,
radiological features and treatment of the spread of
abscesses through cervical spaces of an unusual case
of deep neck infection that was caused by the secondary
infection of the root remnants after extraction.
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Affiliation(s)
- Seda Yilmaz
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Aydın University, Turkey
| | - Burcu Bas
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Turkey
| | - Bora Ozden
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Turkey
| | | | - Senem Cengel Kurnaz
- Department of Ear Nose and Throat, Faculty of Medicine, Ondokuz Mayıs University, Turkey
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