Ishida I, Sagawa M, Suzuki S, Kubo H, Shimada K, Ono S, Matsumura Y, Tanita T, Satoh S, Kondo T, Fujimura S
Department of Thoracic Surgery, Tohoku University, Sendai, Japan.
Kyobu Geka. 2000 Nov;53(12):1058-61.
A 21-year-old female was admitted to our hospital because of high fever, neck swelling, and dyspnea. She was diagnosed as descending necrotizing mediastinitis (DNM) extended from odontogenic infection. On the day of admission, she underwent cervical drainage. Next day, the CT scan showed an abscess below the tracheal bifurcation and bilateral pleural effusion. Mediastinal drainage was performed through a right thoracotomy, and a left thoracic tube was inserted. Anaerobic Peptostreptococcus was found with bacteriological culture. After the mediastinal drainage, bilateral thoracic irrigation was performed through the thoracic tubes. Left thoracic tube was removed on the 8th day and right one was removed on the 20th day after the thoracotomy. She was discharged on the 42nd day. DNM is relatively rare, but it is lethal disease with high mortality. Immediate and sufficient mediastinal drainage is indispensable for the disease.
一名21岁女性因高热、颈部肿胀和呼吸困难入院。她被诊断为源自牙源性感染的下行性坏死性纵隔炎（DNM）。入院当天，她接受了颈部引流。第二天，CT扫描显示气管分叉下方有脓肿及双侧胸腔积液。通过右胸开胸手术进行了纵隔引流，并插入了左胸管。细菌培养发现厌氧消化链球菌。纵隔引流后，通过胸管进行了双侧胸腔冲洗。胸开胸手术后第8天拔除左胸管，第20天拔除右胸管。她于第42天出院。DNM相对少见，但却是一种死亡率很高的致命疾病。对此病立即进行充分的纵隔引流是必不可少的。
