Chen I-Chen, Hsu Jong-Hau, Dai Zen-Kong
Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Pediatr Pulmonol. 2016 May;51(5):E17-20. doi: 10.1002/ppul.23375. Epub 2015 Dec 30.
Descending necrotizing mediastinitis (DNM) is an uncommon disease that can cause significant morbidity and mortality. Herein, we report a 17-month-old girl of DNM with an initial normal chest radiograph followed by rapid clinical deterioration during a period of 4 days, from deep neck infection to mediastinitis and then complicated empyema. She was managed successfully with intravenous antibiotics and surgical debridement by video-assisted thoracic surgery (VATS) and cervical drainage. Early recognition and meticulous intensive care of patients with DNM are important to minimize morbidity and mortality. VATS is an effective and minimally invasive therapeutic strategy in children with DNM.
下行性坏死性纵隔炎（DNM）是一种罕见疾病，可导致严重的发病率和死亡率。在此，我们报告一名17个月大的DNM女童，其最初胸部X线片正常，随后在4天内临床迅速恶化，从深部颈部感染发展为纵隔炎，进而并发脓胸。通过静脉使用抗生素以及电视辅助胸腔镜手术（VATS）和颈部引流进行手术清创，她得到了成功治疗。对DNM患者进行早期识别和精心的重症监护对于将发病率和死亡率降至最低至关重要。VATS是治疗儿童DNM的一种有效且微创的治疗策略。
