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Descending necrotizing mediastinitis associated with spinal cord abscess
Walid Leonardo Dajer-Fadel1, Rafael Borrego-Borrego, Octavio Flores-Calderón
1Department of Cardiothoracic Surgery, General Hospital of Mexico, México City, Mexico. wadafa@hotmail.com
Asian Cardiovascular & Thoracic Annals
|February 23, 2013
Summary
A patient with Ludwig's angina developed a severe spinal cord abscess and descending mediastinitis. Prompt surgical drainage and tracheostomy led to recovery after an 84-day hospital stay.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Ludwig's angina, a severe sublingual space infection, can lead to serious complications.
- Spinal epidural abscesses are rare but critical conditions requiring urgent intervention.
Observation:
- A 58-year-old male with a history of Ludwig's angina presented with a C2-T1 spinal cord abscess.
- The abscess caused vertebral osteomyelitis, spinal cord compression, and quadriparesis.
- Descending mediastinitis developed secondary to the spinal infection.
Findings:
- Surgical intervention included a right posterolateral thoracotomy and cervicotomy for purulent exudate drainage.
- A tracheostomy was performed to manage airway compromise.
- The patient demonstrated recovery and was discharged after 84 days.
Implications:
- This case highlights the potential for severe, life-threatening complications from odontogenic infections.
- Aggressive surgical management is crucial for spinal cord abscesses and associated mediastinitis.
- Early diagnosis and multidisciplinary care are vital for favorable outcomes in complex spinal infections.
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