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Asociación Colombiana de Otorrinolaringología y Cirugía de Cabeza y cuello, Maxilofacial y Estética Facial (ACORL)

2021, Number 3

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Acta de Otorrinolaringología CCC 2021; 49 (3)

Descending necrotizing mediastinitis of odontogenic origin

Pérez-Orbegozo MA, Buitrago-Trujillo AP, Fernández GN, Lora-Aguirre A, Suárez-Olarte LM, Orrego-Colorado JA

Language: Spanish
References: 17
Page: 230-236
PDF size: 287.57 Kb.


ABSTRACT

Introduction: Odontogenic infections affect 80%-90% of the population and can lead to life-threatening complications such as descending necrotizing mediastinitis. Is an acute polymicrobial infection in the mediastinum with a mortality rate of 11%-40%. Its early detection and adequate treatment with antibiotic management and surgical drainage by a multidisciplinary team represent influential factors in the prognosis of the disease. Objective: In this article, we present a case of descending necrotizing mediastinitis in a 34-year-old male patient that originated from an odontogenic infection that required a dental procedure. The patient was hospitalized for worsening clinical status despite antibiotic prophylaxis. Computed axial tomography confirmed the extension of the infection to the mediastinum and the patient was successfully treated with intravenous antibiotherapy and multiple intraoral, cervicotomy, and thoracoscopic surgical drains. Materials and methods: A search was made in global databases, articles were selected by the following MeSH and DeCS terms: “descending necrotizing mediastinitis”, “Ludwig’s angina”, “abscess”, “thoracoscopy”, and their respective English terms, prioritizing those referring to descending necrotizing mediastinitis of odontogenic origin. Conclusions: In descending necrotizing mediastinitis, the combination of early diagnosis, broad-spectrum antibiotic treatment, airway maintenance, and extensive surgical drainage by a multidisciplinary team significantly improves the prognosis of the disease.


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