Acute descending necrotizing mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes

Descending necrotizing mediastinitis (DNM) is a rare, life-threatening form of mediastinitis caused by odontogenic, pharyngeal, or cervical infections. The retropharyngeal space is the most common primary site of infection. Given the fulminant course and high mortality rate, early diagnosis and prompt treatment are important predictors of survival in patients with DNM. Appropriate empirical antibiotic treatment, prompt surgical intervention, and proper management of patients in the intensive care unit can be of vital importance. We present the case of a previously healthy 20-year-old male patient who was successfully cured and discharged from the Clinical Center University of Sarajevo after suffering from a severe form of mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes.

[1]  A. Fiorelli,et al.  Septic shock from descending necrotizing mediastinitis – combined treatment with IgM-enriched immunoglobulin preparation and direct polymyxin B hemoperfusion: a case report , 2018, Journal of Medical Case Reports.

[2]  Atishkumar B. Gujrathi,et al.  Deep neck space infection – A retrospective study of 270 cases at tertiary care center , 2016, World journal of otorhinolaryngology - head and neck surgery.

[3]  Wei Zhang,et al.  Optimal Surgical Options for Descending Necrotizing Mediastinitis of the Anterior Mediastinum , 2014, Cell Biochemistry and Biophysics.

[4]  C. Boedeker,et al.  Descending Necrotizing Mediastinitis Contemporary Trends in Etiology, Diagnosis, Management, and Outcome , 2010 .

[5]  P. L. Atance,et al.  [Descending necrotizing mediastinitis]. , 2010, Archivos de bronconeumologia.

[6]  S. Berrone,et al.  Ten years of descending necrotizing mediastinitis: management of 23 cases. , 2007, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[7]  M. Grabenwoeger,et al.  Descending necrotizing mediastinitis treated with rapid sternotomy followed by vacuum-assisted therapy. , 2007, The Annals of thoracic surgery.

[8]  K. Potaris,et al.  Management of descending necrotizing mediastinitis. , 2004, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[9]  Y. Shim,et al.  Descending necrotizing mediastinitis: a minimally invasive approach using video-assisted thoracoscopic surgery. , 2004, The Annals of thoracic surgery.

[10]  T. Iizuka,et al.  [Hyperbaric oxygen as an adjunctive treatment for descending necrotizing mediastinitis: report of a case]. , 2000, Kyobu geka. The Japanese journal of thoracic surgery.

[11]  F. Shamji,et al.  Optimal treatment of descending necrotising mediastinitis. , 1997, Thorax.

[12]  C. Marty-ané,et al.  Descending necrotizing mediastinitis. Advantage of mediastinal drainage with thoracotomy. , 1994, The Journal of thoracic and cardiovascular surgery.