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Descending necrotizing mediastinitis in the elderly patients

Antonio Mazzella1, Mario Santagata2, Atirge Cecere2

  • 1Thoracic Surgery Unit, Second University of Naples, Italy.

Open Medicine (Warsaw, Poland)
|March 30, 2017
PubMed

Insights

Descending Necrotizing Mediastinitis (DNM) is a severe infection spreading from the neck to the chest, often fatal. This review evaluates its causes and management, particularly in elderly patients.

Area of Science:

  • Infectious Diseases
  • Surgical Pathology
  • Critical Care Medicine

Background:

  • Descending Necrotizing Mediastinitis (DNM) is a severe, polymicrobic infection originating in the head or neck.
  • The infection spreads through deep cervical fascial planes into the mediastinum.
  • DNM is associated with high mortality rates, potentially reaching 40%.

Purpose of the Study:

  • To review the literature on Descending Necrotizing Mediastinitis.
  • To evaluate the pathogenesis and evolution of DNM.
  • To identify optimal therapeutic management strategies, especially for elderly patients.

Main Methods:

  • Comprehensive literature review.
  • Analysis of pathogenesis and disease progression.
  • Evaluation of surgical and therapeutic interventions.

Main Results:

  • DNM is a rapidly progressive condition that can lead to sepsis.
  • High mortality rates underscore the severity of DNM.
  • Management strategies, particularly in elderly populations, require careful consideration.

Conclusions:

  • Effective management of DNM is crucial due to its high mortality.
  • Understanding pathogenesis aids in recognizing and treating DNM.
  • Further research into optimal therapeutic approaches, especially for vulnerable patient groups, is warranted.
Keywords:
Descending necrotizing mediastinitisHead and neck infectionManagement

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