Simmons Michael Keith, Francis Jeffrey, Stefanishina Veronika, Rosenberg Joshua, Havryliuk Tatiana, Farrell Benjamin
The Brooklyn Hospital Center, 121 DeKalb Ave., Brooklyn, NY 11201, USA.
The Brooklyn Hospital Center, 121 DeKalb Ave., Brooklyn, NY 11201, USA.
Am J Emerg Med. 2023 Mar;65:219.e5-219.e7. doi: 10.1016/j.ajem.2022.12.040. Epub 2022 Dec 23.
Acute Descending Necrotizing Mediastinitis is a rare but serious illness that carries a high mortality rate. It is not commonly part of the Emergency Physician's differential diagnoses for the chief complaint of chest pain when there has been no recent instrumentation to the area. Because the disease is so uncommon, there is a relative paucity of reports of the illness.
We report the case of a 58-year-old male with a past medical history of HIV and history of intravenous drug use (IVDU) who presented to the Emergency Department with anterior chest pain for several days in addition to 3 days of fever and chills. The patient's presentation raised concern for intrathoracic infection and the diagnosis of Descending Necrotizing Mediastinitis complicated by internal jugular thrombosis was confirmed by contrast enhanced computed tomography and sonography.
急性下行性坏死性纵隔炎是一种罕见但严重的疾病，死亡率很高。当该区域近期没有器械操作时，它通常不属于急诊医生对胸痛主诉的鉴别诊断范围。由于这种疾病非常罕见，关于该疾病的报道相对较少。
我们报告一例58岁男性病例，该患者有人类免疫缺陷病毒（HIV）病史及静脉注射吸毒史，因前胸痛数天，伴发热、寒战3天就诊于急诊科。患者的临床表现引起了对胸腔内感染的关注，经对比增强计算机断层扫描和超声检查确诊为下行性坏死性纵隔炎并发颈内静脉血栓形成。
