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儿童降主动脉纵隔炎：诊断挑战与不同的治疗方法

Descending Mediastinitis in a Child: Diagnostic Challenges and a Different Treatment Approach.

作者信息

Lira Joana, Santos Joana, Capela Mariana, Rodrigues Joana, Cunha Otília, Carvalho Isabel

机构信息

Pediatrics and Neonatology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, 4434 Vila Nova de Gaia, Portugal.

出版信息

Clin Pract. 2021 Aug 9;11(3):505-508. doi: 10.3390/clinpract11030066.

DOI:10.3390/clinpract11030066
PMID:34449574
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8395469/
Abstract

In children, spontaneous mediastinitis is a rare, severe and commonly misdiagnosed disease. Although standard of care treatment frequently involves surgery, we report a case of mediastinitis in a five-year-old child, successfully treated with 4 weeks of intravenous antibiotics. Ultrasound imaging was used to monitor patient response to conservative treatment while reducing radiation exposure.

摘要

在儿童中，自发性纵隔炎是一种罕见、严重且常被误诊的疾病。尽管标准治疗方案通常涉及手术，但我们报告了一例五岁儿童纵隔炎病例，通过四周的静脉抗生素治疗成功治愈。超声成像用于监测患者对保守治疗的反应，同时减少辐射暴露。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7469/8395469/341f7887d5fc/clinpract-11-00066-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7469/8395469/27ee22e4aa2c/clinpract-11-00066-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7469/8395469/6f1058e97af7/clinpract-11-00066-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7469/8395469/341f7887d5fc/clinpract-11-00066-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7469/8395469/27ee22e4aa2c/clinpract-11-00066-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7469/8395469/6f1058e97af7/clinpract-11-00066-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7469/8395469/341f7887d5fc/clinpract-11-00066-g003.jpg

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本文引用的文献

1
Descending cervical mediastinitis: the multidisciplinary surgical approach.下行性颈纵隔炎：多学科手术方法
Eur Arch Otorhinolaryngol. 2019 Jul;276(7):2075-2079. doi: 10.1007/s00405-019-05471-z. Epub 2019 May 15.
2
A case of descending mediastinitis caused by Streptococcus pyogenes harboring genotype emm25 and sequence type 660.1例由携带emm25基因型和序列类型660的化脓性链球菌引起的降主动脉纵隔炎。
J Infect Chemother. 2017 Jun;23(6):403-406. doi: 10.1016/j.jiac.2016.12.018. Epub 2017 Feb 1.
3
Retrospective Review of Management and Outcomes of Pediatric Descending Mediastinitis.
小儿降主动脉纵隔炎治疗与结局的回顾性研究
Otolaryngol Head Neck Surg. 2016 Jul;155(1):155-9. doi: 10.1177/0194599816634636. Epub 2016 Mar 1.
4
Descending necrotizing mediastinitis: Systematic review on its treatment in the last 6 years, 75 years after its description.下行性坏死性纵隔炎：自其被描述75年后，对过去6年其治疗方法的系统评价。
Head Neck. 2016 Apr;38 Suppl 1:E2275-83. doi: 10.1002/hed.24183. Epub 2016 Feb 1.
5
Acute mediastinitis in children: a nine-year experience.儿童急性纵隔炎：九年经验总结
Tanaffos. 2013;12(2):48-52.
6
Group A Streptococcus causing descending necrotizing mediastinitis: report of a case and literature review.A 组链球菌致下行性坏死性纵隔炎：1 例报告并文献复习
Surg Infect (Larchmt). 2012 Feb;13(1):57-9. doi: 10.1089/sur.2010.049. Epub 2012 Feb 8.
7
Descending necrotising mediastinitis: two case reports and review of the literature.降发性坏死性纵隔炎：两例病例报告并文献复习。
Eur Respir Rev. 2010 Jun;19(116):141-9. doi: 10.1183/09059180.00001110.
8
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Arch Otolaryngol Head Neck Surg. 2008 Apr;134(4):408-13. doi: 10.1001/archotol.134.4.408.
9
Descending mediastinitis: a review.降主动脉纵隔炎：综述
Sao Paulo Med J. 2006 Sep 7;124(5):285-90. doi: 10.1590/s1516-31802006000500011.
10
Imaging in mediastinitis: a systematic review based on aetiology.纵隔炎的影像学检查：基于病因学的系统评价
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