Descending Necrotizing Mediastinitis: Complication of a Simple Dental Infection - 10/09/11
Abstract |
Descending necrotizing mediastinitis (DNM) is a rare complication of periodontic infection. The delay in diagnosis of DNM is believed to contribute to its high mortality rate. We report the case of a healthy 23-year-old man who was seen in the urgent care center, given the diagnosis of dental infection, prescribed penicillin, and sent home. He returned 48 hours later complaining of myalgias, purulent drainage from around his teeth, chest pain, and dyspnea. DNM was diagnosed, and aggressive treatment comprising thoracotomy, cervical incision and drainage, and antibiotics was begun. The patient responded well to treatment and was discharged from the hospital on postoperative day 20. Prompt diagnosis and immediate therapy are imperative for this rare condition. [Haraden BM, Zwemer FL Jr: Descending necrotizing mediastinitis: Complication of a simple dental infection. Ann Emerg Med May 1997;29:683-686.]
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 | From the Department of Medicine* and the Emergency Department,‡ Jewish Hospital at Washington University Medical Center, Washington University School of Medicine, St Louis, MO. |
| Address for reprints: Frank L Zwemer Jr, MD Emergency Department Jewish Hospital at Washington University Medical Center 216 South Kingshighway St. Louis, MO 63110 314-454-7905 Fax 314-454 -7998 E-mail flz2410@bjcmail.carenet.org |
 | Reprint no. 47/1/81215 |
Vol 29 - N° 5
P. 683-686 - mai 1997 Retour au numéro
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