Takao M, Ido M, Hamaguchi K, Chikusa H, Namikawa S, Kusagawa M
Dept of Thoracic and Cardiovascular Surgery, Mie University School of Medicine, Japan.
Eur Respir J. 1994 Sep;7(9):1716-8. doi: 10.1183/09031936.94.07091716.
A rare case of descending necrotizing mediastinitis (DNM) secondary to a nontraumatic retropharyngeal abscess is reported. Even in the era of antibiotics, the mortality of DNM is still around 40%. In spite of drainage of a localized neck abscess, and the administration of systemic antibiotics, the retropharyngeal abscess extended to the pericardial and pleural cavities. Several drainage procedures and thoracotomies were performed to treat the bilateral empyemas and purulent pericarditis. The patient was discharged on hospital day 52. Computed tomography was used to follow the progression of disease, and assess the efficacy of treatment. DNM is a very aggressive form of mediastinitis. The importance of proper mediastinal drainage, as well as the systemic administration of antibiotics, must be emphasized.
本文报道了一例罕见的非创伤性咽后脓肿继发下行性坏死性纵隔炎（DNM）的病例。即使在抗生素时代，DNM的死亡率仍约为40%。尽管对局限性颈部脓肿进行了引流，并给予了全身性抗生素治疗，但咽后脓肿仍蔓延至心包腔和胸腔。为治疗双侧脓胸和化脓性心包炎，进行了多次引流手术和开胸手术。患者于住院第52天出院。使用计算机断层扫描来跟踪疾病进展，并评估治疗效果。DNM是一种极具侵袭性的纵隔炎形式。必须强调纵隔正确引流以及全身性抗生素治疗的重要性。
