Vol 5 No 8 (2019): EPH - International Journal of Medical and Health Science (ISSN: 2456 - 6063)
Articles

Descending necrotizing mediastinitis complicating cervico-facial cellulitis of dental gateway.

Khaoula KARIM
Ibn Sina University Hospital, Hafiane-CherkaouiAvenue, 10100 Rabat, Morocco
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Leila ESSAKALLI HOSSYNI
Ibn Sina University Hospital, Hafiane-CherkaouiAvenue, 10100 Rabat, Morocco
Bio
Published August 25, 2019
Keywords
  • Khaoula KARIM, Leila ESSAKALLI HOSSYNI,
  • cervicofacial cellulitis,
  • dysphagia,
  • mediastinitis,
  • drainage,
  • anerobic germs
  • ...More
    Less
How to Cite
Khaoula KARIM, & Leila ESSAKALLI HOSSYNI. (2019). Descending necrotizing mediastinitis complicating cervico-facial cellulitis of dental gateway. EPH - International Journal of Medical and Health Science (ISSN: 2456 - 6063), 5(8), 12-17. Retrieved from https://ephjournal.com/index.php/mhs/article/view/1516

Abstract

Mediastinitis during cervical cellulitis results from the extension of the cervical infectious process to the mediastinum. This cervico-mediastinal dissemination is favored by the anatomical continuity that exists between these two regions.

The Anglo-Saxon nomenclature attributed the name of descending mediastinitis exclusively to this type of mediastinitis. The dental origin of cellulite is identified by most studies as a factor promoting the extension to the mediastinum especially when the second or third molars are infected.

The initial clinical picture is sometimes poor and can lead to a diagnosis delay. The key examination is cervical CT scan and thoracic CTscan  injected. The treatment consists of large and repeated tissue excisions combined with antibiotic therapy directed against the anaerobic and aerobic germs. We report the case a young, immunocompetent patient with cervical cellulitis of dental origin complicated by anterior and posterior mediastinitis.

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References

  1. F Petitpas, J Mateo, JP Blancal, O Mimoz. Fasciites cervicales nécrosantes. Le Praticien en Anesthésie Réanimation Vol 14 Issue 1. February 2010
  2. Verma N, Iqbal S.M, Murthy J G. Retrospective study of descending cervical mediastinitis. Indian J Otolaryngol. Head Neck Surg 2007; 59: 313-316.
  3. ] Kabiri, H., Manesouri, M., Smahi, M., Al Aziz, S., El Meslout, A., & Benosman, A. (1999). La médiastinite descendante nécrosante. À propos d’une observation. Chirurgie, 124(3), 313–317. doi:10.1016/s0001-4001(99)80099-3
  4. ] management of mediastinitis pleural empyema and aortopulmonary fistula from odontogenic infection. Ann Thorac Surg 19x3 ; 35 : 1X4-7. 10 Chow AM, Rose
  5. J Bédos. Dermohypodermites bactériennes nécrosantes et fasciites nécrosantes : quels antibiotiques et comment?. Annales Francaises d'Anesthésie et de Réanimation. September 2006 : Pages 982-985
  6. Cirino LM, Elias FM, Almeida JL. Descending mediastinitis: a review. Sao Paulo Med. J. 2006; 124: 285–90.
  7. Lanisnik B, Cizmarevic B. Necrotizing fasciitis of the head and neck: 34 cases of a single institution experience. Eur. Arch.
  8. Otorhinolaryngol 2010; 267: 415–21.
  9. Lancerotto L, Tocco I, Salmaso R, Vindigni V, Bassetto F. Necrotizing fasciitis: classification, diagnosis, and management. J. Trauma Acute Care Surg. 2012; 72: 560–6.
  10. J La Rosa, S Bouvier, O Langeron. Prise en charge des cellulites maxillo-faciales. Le Praticien en Anesthésie Réanimation. October 2008: Pages 309-315
  11. Sumi Y, Ogura H, Nakamori Y et al. Nonoperative catheter management for cervical necrotizing fasciitis with and without descending necrotizing mediastinitis. Arch. Otolaryngol. Head Neck Surg. 2008; 134: 750–6.
  12. R Bronchard, C De Vaumas, S Lasocki, K Jabbour, A Geffroy, N Kermarrec, P Montravers. Vacuum-assisted closure in the treatment of perineal necrotizing skin and soft tissue infections. Intensive Care Med. 2008; 34 :1345-1347. This article on PubMed
  13. Dool H, Soetekouw R, van Zanten M, Grooters E. Lemierre’ssyndrome: three cases and a review. Eur. Arch.Otorhinolaryngol. 2005; 262: 651–4.