Kocaeli Med J. 2021; 10(2): 74-77 | DOI: 10.5505/ktd.2021.73792

Descending Necrotizing Mediastinitis: A Rare Case

Erdem Altýparmak¹, Halil Erdem Özel², Ferit Bayakýr³, Serdar Baþer⁴, Saban Eyisarac⁵, Erkan Esen⁶, Ayþe Adin Selçuk^7
1Department of Otorhinolaryngology-Head and Neck Surgery, Karasu State Hospital, Sakarya, Turkey
²Department of Otorinolarengology, University of Health Sciences Derince Training and Research Hospital, Derince, Turkey
³Department of Otorhinolaryngology-Head and Neck Surgery, Arrhythmia Inegol Hospital, Bursa, Turkey
⁴Department of Otorhinolaryngology-Head and Neck Surgery, Private Clinic, Ankara, Turkey
⁵Department of Otorhinolaryngology-Head and Neck Surgery, Hendek State Hospital, Sakarya, Turkey
⁶Department of Otorhinolaryngology-Head and Neck Surgery, Konak Hospital, Kocaeli, Turkey
⁷Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Bahcesehir University, Istanbul, Turkey

Descending necrotizing mediastinitis (DNM) is a rare but highly mortal condition. It is a complication that develops commonly due to severe oropharyngeal or odontogenic infections. Early diagnosis, appropriate antibiotherapy and recovery with surgical intervention is possible. The spread of cervical infection via adjacent anatomical structures leads to mediastinitis. The infection spreads into the pleural and pericardial cavities and even into the abdomen, through the deep fascial spaces. DNM is an infection having high mortality rates (47%) by causing empyema, pleural and pericardial effusion, peritonitis, intrathorasic hemorrhage and cardiac tamponade. In this article, a case of DNM was presented due to its extremely rare incidence, high mortality rate and successful management.

Keywords: deep neck infection, dental abscess, mediastinitis

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Desendan Nekrotizan Mediastinit: Nadir Bir Olgu

Erdem Altýparmak¹, Halil Erdem Özel², Ferit Bayakýr³, Serdar Baþer⁴, Saban Eyisarac⁵, Erkan Esen⁶, Ayþe Adin Selçuk^7
1Karasu Devlet Hastanesi, K.B.B Ana Bilim Dalý, Sakarya, Türkiye
²Saðlýk Bilimleri Üniversitesi, Derince Eðitim ve Araþtýrma Hastanesi, K.B.B. Ana Bilim Dalý, Derince, Türkiye
³Aritmi Ýnegöl Hastanesi, K.B.B Ana Bilim Dalý, Bursa, Türkiye
⁴Özel Klinik, K.B.B Ana Bilim Dalý, Ankara, Türkiye
⁵Hendek Devlet Hastanesi, K.B.B Ana Bilim Dalý, Sakarya, Türkiye
⁶Konak Hastanesi, K.B.B Ana Bilim Dalý, Kocaeli, Türkiye
⁷Bahçeþehir Üniversitesi, K.B.B Ana Bilim Dalý, Ýstanbul Türkiye

Desendan nekrotizan mediastinit (DNM) nadir, fakat yüksek oranda ölümcül seyreden bir durumdur. Sýklýkla orofarengeal veya odontojenik þiddetli enfeksiyonlara baðlý geliþen bir komplikasyondur. Erken taný, uygun antibiyoterapi ve cerrahi giriþimle iyileþme olasýdýr. Servikal enfeksiyonun komþuluk yolu ile yayýlmasý mediastinite yol açar. Enfeksiyon plevral ve perikardiyal boþluklara ve hatta batýn içine, boyundaki derin fasyalarýn oluþturduðu boþluklar boyunca yayýlýr. Ampiyem, plevral ve perikart efüzyonu, peritonit, intratorasik hemoraji ve kardiyak tamponada neden olan ve mortalitesi yüksek bir enfeksiyondur (%47). Bu yazýda, oldukça nadir görülmesi, yüksek mortaliteye sahip olmasý ve baþarýlý tedavisi nedeniyle DNM’li olgu sunuldu.

Anahtar Kelimeler: derin boyun enfeksiyonu, diþ apsesi, mediastinit

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