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Descending necrotising mediastinitis: two case reports and review of the literature.

Authors
  • Weaver, E
  • Nguyen, X
  • Brooks, M A
Type
Published Article
Journal
European Respiratory Review
Publisher
European Respiratory Society
Publication Date
Jun 01, 2010
Volume
19
Issue
116
Pages
141–149
Identifiers
DOI: 10.1183/09059180.00001110
PMID: 20956183
Source
Medline
License
Unknown

Abstract

Descending necrotising mediastinitis is a rare and serious infection with a high mortality rate, which complicates pharyngeal or odontogenic infection. Early recognition and treatment are essential in order to minimise morbidity. Evaluation with computed tomography is necessary to confirm the diagnosis and facilitate surgical planning. In addition to prompt empirical antibiotic therapy, surgical intervention is necessary in nearly all cases. Surgical drainage and debridement may be performed through cervicotomy alone, or through combined cervicotomy and thoracotomy, depending upon the extent of disease. Hyperbaric oxygen therapy may play an auxiliary role. We present two recent cases with characteristic imaging findings, and review the relevant literature.

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