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拔牙后坏死性纵隔炎:一例报告

Necrotizing Mediastinitis Following Dental Extraction: A Case Report.

作者信息

Pinkston Justin, Khoury Charles A, Raper Jaron D

机构信息

University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama.

出版信息

Clin Pract Cases Emerg Med. 2022 Feb;6(1):45-48. doi: 10.5811/cpcem.2021.11.54567.

Abstract

INTRODUCTION

Necrotizing mediastinitis is a rare complication following a dental procedure. It is frequently lethal and requires prompt diagnosis with advanced imaging, administration of broad-spectrum antimicrobials, and early surgical consultation.

CASE REPORT

A 19-year-old, otherwise healthy male presented to the emergency department with chest pain, muffled voice, and facial and neck swelling six days following dental extraction. He was found to have a retropharyngeal abscess causing necrotizing mediastinitis and septic shock. The patient was started on broad-spectrum antimicrobials, required 10 surgical procedures, and experienced a prolonged hospitalization.

CONCLUSION

Consider necrotizing mediastinitis in patients presenting with chest pain and signs of retropharyngeal infection after dental procedures. Prompt imaging, antimicrobial therapy, and surgical consultation is critical in treating this frequently fatal disease.

摘要

引言

坏死性纵隔炎是牙科手术后一种罕见的并发症。它常常是致命的,需要通过先进的影像学检查进行快速诊断,给予广谱抗菌药物,并尽早进行外科会诊。

病例报告

一名19岁、身体健康的男性在拔牙后六天因胸痛、声音低沉以及面部和颈部肿胀就诊于急诊科。他被发现患有导致坏死性纵隔炎和感染性休克的咽后脓肿。患者开始接受广谱抗菌药物治疗,接受了10次外科手术,住院时间延长。

结论

对于牙科手术后出现胸痛和咽后感染体征的患者,应考虑坏死性纵隔炎。快速的影像学检查、抗菌治疗和外科会诊对于治疗这种常常致命的疾病至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa15/8885237/0d2fad893560/CPCEM-6-45-g001.jpg

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