Catastrophic descending necrotizing mediastinitis of the anterior and posterior compartments: A case report

Abstract

Descending necrotizing mediastinitis (DNM) is a medical emergency with a high associated morbidity and mortality.DNM may arise secondary to primary odontogenic or neck infection in susceptible patients and it may spread contiguously via the “danger” space to the mediastinum. This case report is focused on complications following an odontogenic infection in a healthy 48-year-old male that led to a massive inflammation associated an extensive empyema.After chest and neck computed tomographic scan a diagnosis of cervical necrotizing fasciitis with DNM was made. A multidisciplinary approach with an urgent surgical intervention and the finding of the right antibiotic therapy resulted to be successful. After 2 weeks the patient was dismissed in better health condition.

Keywords

• Cervical necrotizing fasciitis (CNF)
• Descending necrotizing mediastinitis (DNM)
• Odontogenic infection
• Computed tomography scan
• Empyema
• Video-assisted thorascopic surgery (VATS)