Desenden Nekrotizan Mediastinit
Özet
Desendan nekrotizan mediastinit (DNM), orofaringeal veya servikofasiyal enfeksiyonların mediastene yayılmasıyla oluşan nadir ancak ölümcül bir enfeksiyondur. Genellikle aerobik ve anaerobik bakterilerden kaynaklanır. DNM, yayılım kapasitesi ve hızlı ilerlemesi nedeniyle erken tanı ve tedavi gerektirir. Ana semptomlar boyun ağrısı, subkutan amfizem ve disfaji olup, göğüs ağrısı ve solunum sıkıntısı da eşlik edebilir. Tedavinin temel unsurları geniş spektrumlu antibiyoterapi ve cerrahi drenajdır. Cerrahi tedavi süpüratif enfeksiyonun yayılımına göre planlanır. Erken müdahale ve uygun tedavi, mortalite oranlarını düşürmek için kritik öneme sahiptir.
Descending necrotizing mediastinitis (DNM) is a rare but fatal infection that occurs when oropharyngeal or cervicofacial infections spread to the mediastinum. It is commonly caused by aerobic and anaerobic bacteria. Due to its capacity for rapid spread, early diagnosis and treatment are essential. The main symptoms include neck pain, subcutaneous emphysema, and dysphagia, often accompanied by chest pain and respiratory distress. Treatment primarily involves broad-spectrum antibiotics and surgical drainage, with the surgical approach depending on the extent of the infection. Early intervention and appropriate treatment are crucial for reducing mortality rates.
Referanslar
Pearse Jr, H.E. Mediastinitis following cervical suppuration. Annals of surgery,1938; 108(4):588-611.
Estrera, A. S., Landay, M. J., Grisham, J. M. Descending necrotizing mediastinitis. Surgery, gynecology & obstetrics,1983; 157(6): 545-552.
Ishinaga, H., Otsu, K., Sakaida, H. Descending necrotizing mediastinitis from deep neck infection. European Archives of Oto-Rhino-Laryngology,2013; 270: 1463-1466.
Ridder, G. J., Maier, W., Kinzer, S. Descending necrotizing mediastinitis: contemporary trends in etiology, diagnosis, management, and outcome. Annals of surgery,2010; 251(3): 528-534.
Wheatley, M. J., Stirling, M. C., Kirsh, M. M. Descending necrotizing mediastinitis: transcervical drainage is not enough. The Annals of thoracic surgery, 1990; 49(5): 780-784.
Marty-Ane, C. H., Alauzen, M., Alric, P. Descending necrotizing mediastinitis: advantage of mediastinal drainage with thoracotomy. The Journal of Thoracic and Cardiovascular Surgery, 1994;107(1):55-61.
Sancho, L. M. M., Minamoto, H., Fernandez, A. Descending necrotizing mediastinitis: a retrospective surgical experience. European journal of cardio-thoracic surgery, 1999; 16(2): 200-205.
Sumi, Y. Descending necrotizing mediastinitis: 5 years of published data in J apan. Acute Medicine & Surgery, 2015; 2(1): 1-12.
Weaver, E., Nguyen, X., Brooks, M. A. Descending necrotising mediastinitis: two case reports and review of the literature. European Respiratory Review,2010; 19(116): 141-149.
Ekinci M., Turna A. Mediastinal enfeksiyonlar. Güncel Göğüs Hastalıkları Serisi, 2020; 8 (3): 90-106
Vodička, J., Geiger, J., Židková, A. Acute Mediastinitis–Outcomes and Prognostic Factors of Surgical Therapy (A Single-Center Experience). Annals of Thoracic and Cardiovascular Surgery, 2022; 28(3): 171-179.
Pastene, B., Cassir, N., Tankel, J. Mediastinitis in the intensive care unit patient: a narrative review. Clinical Microbiology and Infection,2020; 26(1): 26-34.
Pinto, A., Scaglione, M., Scuderi, M. G. Infections of the neck leading to descending necrotizing mediastinitis: role of multi-detector row computed tomography. European journal of radiology, 2008; 65(3): 389-394.
Mark, R., Song, S., Mark, P. Taking heed of the ‘danger space’: acute descending necrotising mediastinitis secondary to primary odontogenic infection. Case Reports, 2018; bcr-2018.
Şanlı M. Desendan nekrotizan mediastinit. Yüksel M., Balcı A.E. (ed). Göğüs Cerrahisi kırmızı kitap içinde. Ankara: Nobel Tıp Kitabevi; 2015.p.699-704
Exarhos, D. N., Malagari, K., Tsatalou, E. G. Acute mediastinitis: spectrum of computed tomography findings. European radiology,2005; 15: 1569-1574.
De Palma, A., Cantatore, M. G., Di Gennaro, F. Multidisciplinary approach in the treatment of descending necrotizing mediastinitis: twenty-year single-center experience. Antibiotics,2022; 11(5): 664.
Misthos, P., Katsaragakis, S., Kakaris, S. Descending necrotizing anterior mediastinitis: analysis of survival and surgical treatment modalities. Journal of oral and maxillofacial surgery,2007; 65(4): 635-639.
Referanslar
Pearse Jr, H.E. Mediastinitis following cervical suppuration. Annals of surgery,1938; 108(4):588-611.
Estrera, A. S., Landay, M. J., Grisham, J. M. Descending necrotizing mediastinitis. Surgery, gynecology & obstetrics,1983; 157(6): 545-552.
Ishinaga, H., Otsu, K., Sakaida, H. Descending necrotizing mediastinitis from deep neck infection. European Archives of Oto-Rhino-Laryngology,2013; 270: 1463-1466.
Ridder, G. J., Maier, W., Kinzer, S. Descending necrotizing mediastinitis: contemporary trends in etiology, diagnosis, management, and outcome. Annals of surgery,2010; 251(3): 528-534.
Wheatley, M. J., Stirling, M. C., Kirsh, M. M. Descending necrotizing mediastinitis: transcervical drainage is not enough. The Annals of thoracic surgery, 1990; 49(5): 780-784.
Marty-Ane, C. H., Alauzen, M., Alric, P. Descending necrotizing mediastinitis: advantage of mediastinal drainage with thoracotomy. The Journal of Thoracic and Cardiovascular Surgery, 1994;107(1):55-61.
Sancho, L. M. M., Minamoto, H., Fernandez, A. Descending necrotizing mediastinitis: a retrospective surgical experience. European journal of cardio-thoracic surgery, 1999; 16(2): 200-205.
Sumi, Y. Descending necrotizing mediastinitis: 5 years of published data in J apan. Acute Medicine & Surgery, 2015; 2(1): 1-12.
Weaver, E., Nguyen, X., Brooks, M. A. Descending necrotising mediastinitis: two case reports and review of the literature. European Respiratory Review,2010; 19(116): 141-149.
Ekinci M., Turna A. Mediastinal enfeksiyonlar. Güncel Göğüs Hastalıkları Serisi, 2020; 8 (3): 90-106
Vodička, J., Geiger, J., Židková, A. Acute Mediastinitis–Outcomes and Prognostic Factors of Surgical Therapy (A Single-Center Experience). Annals of Thoracic and Cardiovascular Surgery, 2022; 28(3): 171-179.
Pastene, B., Cassir, N., Tankel, J. Mediastinitis in the intensive care unit patient: a narrative review. Clinical Microbiology and Infection,2020; 26(1): 26-34.
Pinto, A., Scaglione, M., Scuderi, M. G. Infections of the neck leading to descending necrotizing mediastinitis: role of multi-detector row computed tomography. European journal of radiology, 2008; 65(3): 389-394.
Mark, R., Song, S., Mark, P. Taking heed of the ‘danger space’: acute descending necrotising mediastinitis secondary to primary odontogenic infection. Case Reports, 2018; bcr-2018.
Şanlı M. Desendan nekrotizan mediastinit. Yüksel M., Balcı A.E. (ed). Göğüs Cerrahisi kırmızı kitap içinde. Ankara: Nobel Tıp Kitabevi; 2015.p.699-704
Exarhos, D. N., Malagari, K., Tsatalou, E. G. Acute mediastinitis: spectrum of computed tomography findings. European radiology,2005; 15: 1569-1574.
De Palma, A., Cantatore, M. G., Di Gennaro, F. Multidisciplinary approach in the treatment of descending necrotizing mediastinitis: twenty-year single-center experience. Antibiotics,2022; 11(5): 664.
Misthos, P., Katsaragakis, S., Kakaris, S. Descending necrotizing anterior mediastinitis: analysis of survival and surgical treatment modalities. Journal of oral and maxillofacial surgery,2007; 65(4): 635-639.
