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前纵隔和后纵隔灾难性下行性坏死性纵隔炎:一例报告

Catastrophic descending necrotizing mediastinitis of the anterior and posterior compartments: A case report.

作者信息

Benedetto Caterina, Tanzariello Vincenzo Nicola, Militi Annalisa, Fallica Gianluca Elio, Marco Delia Di, Monaco Francesco, Ugo Barbaro

机构信息

Department of Radiology, I.R.C.C.S. Centro Neurolesi Bonino Pulejo, P.O. Piemonte, Viale Europa 45, 98124 Messina, Italy.

ENT Practice, 98123 Messina, Italy.

出版信息

Radiol Case Rep. 2020 Aug 8;15(10):1832-1836. doi: 10.1016/j.radcr.2020.07.040. eCollection 2020 Oct.

Abstract

Descending necrotizing mediastinitis (DNM) is a medical emergency with a high associated morbidity and mortality. DNM may arise secondary to primary odontogenic or neck infection in susceptible patients and it may spread contiguously via the "danger" space to the mediastinum. This case report is focused on complications following an odontogenic infection in a healthy 48-year-old male that led to a massive inflammation associated an extensive empyema. After chest and neck computed tomographic scan a diagnosis of cervical necrotizing fasciitis with DNM was made. A multidisciplinary approach with an urgent surgical intervention and the finding of the right antibiotic therapy resulted to be successful. After 2 weeks the patient was dismissed in better health condition.

摘要

下行性坏死性纵隔炎(DNM)是一种具有高发病率和死亡率的医疗急症。DNM可能继发于易感患者的原发性牙源性或颈部感染,并可通过“危险”间隙连续蔓延至纵隔。本病例报告聚焦于一名48岁健康男性牙源性感染后的并发症,该感染导致了大规模炎症并伴有广泛的脓胸。经胸部和颈部计算机断层扫描后,诊断为伴有DNM的颈部坏死性筋膜炎。采取多学科方法,进行紧急手术干预并找到合适的抗生素治疗,结果取得了成功。两周后,患者健康状况好转出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a195/7417671/89ffb7c87d8e/gr1.jpg

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