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[Mediastinal abscess due to endotracheal intubation]
1Department of Internal Medicine, Tokyo Women's Medical College Second Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi
|September 1, 1993
Summary
A woman with poorly controlled diabetes mellitus developed a severe pharyngeal to mediastinal abscess. Prompt surgical drainage and antibiotics successfully treated the infection and stabilized her blood sugar.
Area of Science:
- Endocrinology
- Infectious Diseases
- Surgical Pathology
Background:
- A 38-year-old female with a history of insulin-dependent diabetes mellitus (IDDM) presented with hypoglycemic coma.
- Inadequate glycemic control in patients with diabetes mellitus can lead to serious complications.
Observation:
- Following intubation for hypoglycemic coma, the patient developed a sore throat, neck swelling, and fever.
- CT imaging revealed a continuous abscess with air bubbles extending from the pharynx to the mediastinum.
Findings:
- The abscess culture identified alpha-streptococcus as the causative pathogen.
- Surgical incision and drainage, combined with broad-spectrum antibiotics (ampicillin, cefmetazole, clindamycin), were initiated.
- The patient's condition improved, with abscess resolution and improved glycemic control through insulin and diet management.
Implications:
- This case highlights the potential for deep neck and mediastinal infections in patients with poorly controlled diabetes.
- Effective management requires a multidisciplinary approach involving infectious disease specialists, surgeons, and endocrinologists.
- Aggressive treatment of infections is crucial for preventing life-threatening complications in diabetic patients.