Management of a difficult infectional disease: Descending necrotizing mediastinitis

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dc.authoridkaramustafaoglu, yekta altemur/0000-0002-5491-1219
dc.authoridYANIK, FAZLI/0000-0002-8931-5329
dc.authoridYORUK, YENER/0000-0001-6309-3054
dc.authorwosidkaramustafaoglu, yekta altemur/S-9512-2019
dc.authorwosidYanık, Fazlı/W-4597-2017
dc.authorwosidYoruk, Yener/W-4285-2017
dc.authorwosidErtan, Asli/AAE-6201-2021
dc.contributor.authorYanik, Fazli
dc.contributor.authorKaramustafaoglu, Yekta Altemur
dc.contributor.authorYoruk, Yener
dc.date.accessioned2024-06-12T11:07:09Z
dc.date.available2024-06-12T11:07:09Z
dc.date.issued2018
dc.departmentTrakya Üniversitesien_US
dc.description.abstractIntroduction: Descending Necrotizing Mediastinitis (DNM) is the fatal form of mediastinitis and mostly develops as a complication of peritonsillar abscesses or dental-odontogenic infections. The aim of this study is to evaluate clinical and surgical feature of the patients with DNM who were managed in our clinic. Methodology: We retrospectively evaluated 13 consecutive patients with the diagnosis of DNM between February 2005 and February 2018. All of them had the typical physical appearance, history and radiological findings. Results: Ten (77%) patients were male, 3 (23%) patients were female with a median age of 48.2 (18-76 years). All patients underwent Cervico-Mediastinal Drainage (CMD) with debridement of the necrotic and infected tissues. Other supplimantary surgical procedures were tube thoracostomy (n = 8), VATS mediastinal drainage (n = 4), tracheostomy (n = 2) and thoracatomy (n = 1). The median time to diagnosis of DNM, tube drainage (inserted after CMD) removal time, tube thoracostomy removal time, lenght of hospital stay were 1.8 (range 1-4) days, 13.6 (range 10-20), 12.6 days (range 10-27) and 21.5 days (range 15-30), respectively. Appropriate and potent antibiotics were used according to the fever-CRP response with the consultation on infectious disease specialist. Two patients were lost due to fulminant sepsis (n = 1) and massive cervical haemorrhage (n = 1). Overall mortality rate was 15%. Complications were recorded in 6 patients (46%). Conclusions: The critical point in the management of DNM is the correct diagnosis, rapid surgical intervention with antibiotherapy and close follow-up for possible complications. We concluded that the combination of minimally invasive management as VATS-tube thoracostomy with CMD is the most appropriate surgical interventions.en_US
dc.identifier.doi10.3855/jidc.10482
dc.identifier.endpage754en_US
dc.identifier.issn1972-2680
dc.identifier.issue9en_US
dc.identifier.pmid31999633en_US
dc.identifier.scopus2-s2.0-85055266904en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage748en_US
dc.identifier.urihttps://doi.org/10.3855/jidc.10482
dc.identifier.urihttps://hdl.handle.net/20.500.14551/21932
dc.identifier.volume12en_US
dc.identifier.wosWOS:000447036000009en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherJ Infection Developing Countriesen_US
dc.relation.ispartofJournal Of Infection In Developing Countriesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectInfectionen_US
dc.subjectNecrotizingen_US
dc.subjectMediastinitisen_US
dc.subjectFatalen_US
dc.subjectDeveloping Countryen_US
dc.titleManagement of a difficult infectional disease: Descending necrotizing mediastinitisen_US
dc.typeArticleen_US

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