Related Experiment Videos

["Descending necrotizing mediastinitis" due to deep neck infections. Incidence and management]

A Sandner1, J Börgermann, S Kösling

  • 1Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität, Halle-Wittenberg. annett.sandner@medizin.uni-halle.de

HNO
|April 21, 2006
PubMed
Abstract

Insights

Descending necrotizing mediastinitis (DNM) is a severe infection spreading from the neck to the chest. Early diagnosis and aggressive surgical intervention are crucial for survival.

Area of Science:

  • Medical research
  • Surgical pathology
  • Infectious diseases

Background:

  • Descending necrotizing mediastinitis (DNM) is a rare, life-threatening complication of deep neck infections.
  • It results from the rapid downward spread of oropharyngeal infections into the mediastinum via facial planes.

Observation:

  • A study treated 6 patients with DNM between 1997 and 2004.
  • Common causes included peritonsillar, parapharyngeal, and odontogenic abscesses.
  • Risk factors like diabetes and alcoholism were noted, with a mean diagnosis delay of 6.3 days.

Findings:

  • Four out of six patients survived, with a mean hospitalization of 48.2 days.
  • Two patients died from sepsis and multiorgan failure despite intensive care.

Implications:

  • Prompt detection of DNM is critical.
  • Persistent symptoms post-oropharyngeal infection treatment warrant investigation, potentially masked by analgesics.
  • Immediate CT scans, aggressive surgical drainage, and debridement are essential to reduce high mortality rates.

Related Concept Videos

Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...