Summary A case report : Gas forming deep neck infection spreading down to the mediastinum:—Descending necrotizing mediastinitis—

概要

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We report a case of a descending necrotizing mediastinitis. A 47-year-old male presented with sore throat, high grade fever and anterior neck swelling. Physical examination revealed an anterior neck diffuse redness and swelling with crepitance. Both X-ray and CT scan films showed gas formations in the bilateral neck and the upper mediastinum. The gas formation extended to the pretracheal and the retropharyngeal space down to the level of the tracheal bifurcation. The patients immediately underwent cervicotomy and transcervical drainage surgery of the upper mediastinum. A tracheostomy was not performed. During the surgery, the origin of the infection was not identified. A culture of the pus obtained from the neck wound revealed Peptostreptococcus. The patients was treated with antibiotics and debridement of infectious tissues. He completely recovered and was discharged from our institute on the 49th postoperative day. This case suggests that early recognition of this life threatenig complication of the deep neck infection and immediate surgical drainage are essential.
特定非営利活動法人日本頭頸部外科学会の論文