399 results match your criteria descending necrotizing


Periapical abscess progressing to parotitis and descending necrotizing mediastinitis with thoracic abscess in a patient on etanercept: A case report.

Int J Crit Illn Inj Sci 2020 Oct-Dec;10(4):220-223. Epub 2020 Dec 29.

Department of Emergency Medicine, Vidant Medical Center, East Carolina University Brody School of Medicine, Greenville, NC, USA.

Patients on Type 2 biologics, such as etanercept, are at increased risk for aggressive infections. This may be further exacerbated by concomitant systemic corticosteroid use or comorbidities such as diabetes. We report a case of a patient with rheumatoid arthritis on etanercept with poor dentition and periodontal disease, who developed parotitis with peritonsillar abscess and descending necrotizing mediastinitis (DNM) with periaortic abscess arising from a periapical abscess. Read More

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December 2020

Re: Perforated descending colon adenocarcinoma manifesting as necrotizing fasciitis.

ANZ J Surg 2021 04;91(4):763-764

Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

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[Descending Necrotizing Mediastinitis with Empyema Necessitated Two Performances of Surgical Drainage for Successful Treatment:Report of a Case].

Kyobu Geka 2021 Apr;74(4):313-316

Department of Surgery, Kagawa Prefectural Shirotori Hospital, Higashikagawa, Japan.

The case was a 57-year-old woman. She visited a local doctor with a chief complaint of sore throat. A retropharyngeal abscess was suspected, and she was referred to our otolaryngology. Read More

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Streptococcus anginosus group infection as a predictor for the progression of descending necrotizing mediastinitis.

Ann Palliat Med 2021 Apr 22;10(4):4008-4016. Epub 2021 Mar 22.

Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, Tokyo, Japan.

Background: The prognosis of descending necrotizing mediastinitis (DNM), especially that extending inferiorly to the carina, remains poor. The identification of additional prognostic factors may improve the prognosis.

Methods: We retrospectively analyzed six patients who underwent thoracic surgery for DNM extending to the anterior and posterior mediastinum inferior to the carina (Endo classification type IIB) from 2014 to 2020. Read More

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A new classification of descending necrotizing mediastinitis and surgical strategies.

Ann Transl Med 2021 Feb;9(4):356

Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Clinical Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Background: Descending necrotizing mediastinitis (DNM) is an inflammation occurring in the oropharynx and descending to the deep cervical space and mediastinum, which is a serious infectious disease. The investigation of a new classification system and treatment methods for DNM is still necessary.

Methods: A total of 139 patients with DNM caused by odontogenic or pharyngeal infection were retrospectively analyzed in last 20 years in the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. Read More

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February 2021

Identification of risk factors for mortality and delayed oral dietary intake in patients with open drainage due to deep neck infections: A nationwide study using a Japanese inpatient database.

Head Neck 2021 Mar 2. Epub 2021 Mar 2.

Department of Otolaryngology Head and Neck Surgery, Kansai Medical University, Hirakata, Japan.

Backgrounds: Data on risk factors for deep neck infection including descending necrotizing mediastinitis (DNM) have been limited. Using a nationwide database, the aim was identifying the factors related to patient death and delay in recovering oral intake.

Methods: Data of 4949 patients were extracted from a Japanese inpatient database between 2012 and 2017. Read More

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A case of cervical fasciitis complicated by mediastinitis and pre-peritoneal abscess: the role of video-assisted thoracoscopic surgery.

Indian J Thorac Cardiovasc Surg 2021 Mar 5;37(2):195-199. Epub 2020 Sep 5.

Unit of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Apuane Hospital, Via E. Mattei 31, 54100 Massa, Italy.

Cervical necrotizing fasciitis (CNF) is the name for a group of bacterial infections characterized by necrosis of the fascia and subcutaneous cellular tissue of the neck. Descending necrotizing mediastinitis (DNM) is a well-known and feared complication of CNF that severely affects the prognosis. Abdominal involvement is rare. Read More

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Characteristics and outcomes of Ludwig's angina in patients admitted to the intensive care unit: A 6-year retrospective study of 29 patients.

J Dent Sci 2020 Dec 10;15(4):445-450. Epub 2020 Jan 10.

Department of Dentistry, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu, China.

Background/purpose: Ludwig's angina (LA) still presents regularly and various characteristics are documented, but patients admitted to the Intensive Care Unit (ICU) has not been studied. The purpose of this study was to investigate the clinical characteristics and outcomes of patients with LA who were admitted to ICU.

Materials And Methods: We retrospectively reviewed all 29 patients with LA who were admitted to the ICU of a university hospital from January 2013 to October 2018. Read More

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December 2020

Staphylococcus aureus descending necrotizing mediastinitis in a healthy adult.

Ann Thorac Surg 2020 Dec 5. Epub 2020 Dec 5.

Ascension-St John Hospital, Grosse Pointe Woods, Michigan, Department of Infectious Diseases, Ascension-St. John Hospital, Grosse Pointe Woods, MI 48236.

Descending necrotizing mediastinitis (DNM) is a severe form of mediastinitis with high mortality rates due to the rapid progression of infection into the mediastinum through tissue planes, often from a dental or pharyngeal source. We present a case of monomicrobial methicillin resistant Staphylococcus aureus (MRSA)-DNM in a young healthy male who was initially misdiagnosed with strep throat. This is well described in the pediatric literature however DNM in adults is typically polymicrobial and occurs in those with comorbidities such as diabetes mellitus and older age. Read More

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December 2020

[Retrospective analysis of the effectiveness of treating multi-space infection combined with descending necrotizing mediastinitis at oral maxillofacial and cervical region via multidisciplinary team collaboration].

Zhonghua Kou Qiang Yi Xue Za Zhi 2020 Dec;55(12):952-957

Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

To explore the strategy and experience for treating maxillofacial and cervical multi-space infection combined with descending necrotizing mediastinitis (DNM) via multidisciplinary team (MDT) collaboration. A total of 36 patients with maxillofacial and cervical multi-space infection complicated with DNM admitted to the First Affiliated Hospital of Zhengzhou University from July 2011 to July 2019 were included in the study. The clinical data of the patients were retrospectively analyzed, including gender, age, symptoms at admission, source of infection, preoperative and postoperative evaluation indicators, MDT strategy and prognosis. Read More

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December 2020

Oral manifestations of COVID-19 disease: A review article.

Dermatol Ther 2021 Jan 13;34(1):e14578. Epub 2020 Dec 13.

Leishmaniasis Research Center, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran.

Dysgeusia is the first recognized oral symptom of novel coronavirus disease (COVID-19). In this review article, we described oral lesions of COVID-19 patients. We searched PubMed library and Google Scholar for published literature since December 2019 until September 2020. Read More

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January 2021

Deep Neck Infection Complicated by Phlegmonous Esophagitis and Mediastinitis.

Ann Thorac Surg 2020 Nov 21. Epub 2020 Nov 21.

Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.

Descending necrotizing mediastinitis is a life-threatening disease that extends into the pretracheal, perivascular, retrovisceral, and/or prevertebral spaces, generally sparing the esophagus. We report a case of deep neck abscess complicated by phlegmonous esophagitis and mediastinitis. The patient was successfully treated with antibiotics and surgery, combining transcervical and bilateral thoracoscopic transthoracic mediastinal drainage. Read More

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November 2020

Infectious Mononucleosis Resulting in Acute Necrotizing Mediastinitis: A Case Report and Literature Review.

Eur J Case Rep Intern Med 2020 24;7(11):001829. Epub 2020 Aug 24.

Internal Medicine and Infectious Diseases Department, C.H.U de Charleroi, Lodelinsart, Belgium.

The serological prevalence of Epstein-Barr virus (EBV) among young adults exceeds 90% worldwide. Even though EBV primary infection is usually benign, severe complications can occur in adolescents and young adults and so the disease must be promptly diagnosed. The development of an oropharyngeal abscess leading to a descending necrotizing mediastinitis (DNM) is exceptional and potentially lethal, so early diagnosis with a CT scan, appropriate antibiotics and surgery are essential. Read More

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Reconstruction of Lower Limb Necrotizing Fasciitis by Hydrosurgical Debridement and Multiperforator Anterolateral Thigh Flap.

Plast Reconstr Surg Glob Open 2020 Sep 24;8(9):e3150. Epub 2020 Sep 24.

Department of Plastic and Reconstructive Surgery, Yachiyo Medical Center, Tokyo Women's Medical University, Yachiyo-shi, Chiba, Japan.

The authors describe a surgical treatment that optimally combined the use of the hydrosurgical system and a free multiperforator anterolateral thigh flap to prevent lower limb amputation in a severe case of necrotizing fasciitis. A 43-year-old woman was diagnosed with necrotizing fasciitis, and amputation was performed at the level of the metatarsal shafts with an emergency debridement using the hydrosurgical system. In the second reconstructive surgery, a free anterolateral thigh flap measuring 28 × 8 cm was harvested using the left thigh as the donor site and the vascular pedicle was made up of a total of 3 vessels, 2 perforating arteries from the descending branch of the lateral circumflex femoral artery, and 1 oblique branch from the lateral circumflex femoral artery. Read More

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September 2020

Predictive factors of lethality and complications of deep fascial space infections of the neck.

Rev Col Bras Cir 2020 Sep 4;47:e20202524. Epub 2020 Sep 4.

- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Cirurgia, Disciplina de Cirurgia de Cabeça e Pescoço - São Paulo - SP - Brasil.

Objective: to identify predictive factors for lethality and complications of deep fascial space infections of the neck (DFSIN), establishing an early and aggressive treatment in the neck before the progression to descending mediastinitis.

Methods: we retrospectively analyzed 133 cases of DFSIN treated at Discipline of Head and Neck Surgery of the Medicine School of Santa Casa de Misericórdia de São Paulo. We accessed demographic characteristics, associated diseases, clinical presentation, laboratorial tests, length of hospital stay, number of involved anatomic neck spaces, intra-operative and microbiology findings. Read More

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September 2020

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

Radiol Case Rep 2020 Oct 8;15(10):1832-1836. Epub 2020 Aug 8.

Department of Radiology, I.R.C.C.S. Centro Neurolesi Bonino Pulejo, P.O. Piemonte, Viale Europa 45, 98124 Messina, Italy.

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. Read More

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October 2020

18F-fluorodeoxyglucose positron emission tomography/computed tomography findings in descending necrotizing mediastinitis and cervical vertebral osteomyelitis in a cancer patient: A case report.

Medicine (Baltimore) 2020 Jul;99(30):e21353

Department of Nuclear Medicine.

Rationale: A deep neck infection (DNI) with descending necrotizing mediastinitis (DNM) has great clinical importance because of its high morbidity and mortality, particularly when associated with predisposing underlying disease. With the expanding clinical use of F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), it may be necessary to perform FDG PET/CT for immediate diagnosis and treatment of DNM. To the best of our knowledge, this is the first case report of DNI with DNM diagnosed based on FDG PET/CT findings. Read More

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Successful Treatment with the Chin-down Maneuver of Dysphagia Secondary to Descending Necrotizing Mediastinitis: A Case Study.

Prog Rehabil Med 2020 20;5:20200002. Epub 2020 Feb 20.

Department of Rehabilitation Medicine, School of Medicine, Tokai University Hospital, Kanagawa, Japan.

Background: Descending necrotizing mediastinitis is a potentially fatal polymicrobial infection that often leads to dysphagia after treatment. Such dysphagia is likely the result of fibrosis and scarring from inflammatory changes in the fascial space. A case is presented in which the mechanism of dysphagia was verified using two-dimensional analysis of the muscle lengths of the suprahyoid and infrahyoid muscles. Read More

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February 2020

Low descending aorta flow is associated with adverse feeding outcomes in neonates with small left-sided structures.

Int J Cardiovasc Imaging 2021 Jan 1;37(1):269-273. Epub 2020 Aug 1.

The Labatt Family Heart Centre, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Feeding intolerance and necrotizing enterocolitis (NEC) cause significant morbidity in neonates with duct-dependent systemic circulations. Whether these complications are associated with low blood flow to the bowel is unproven. The aim of this study was to determine whether low descending aortic (DAO) flow is associated with adverse feeding outcomes in neonates with small left-sided structures, including borderline left ventricle and hypoplastic left heart syndrome (HLHS). Read More

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January 2021

Complications of peritonsillar abscess.

Ann Clin Microbiol Antimicrob 2020 Jul 30;19(1):32. Epub 2020 Jul 30.

Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99 Aarhus N, Aarhus, 8200, Denmark.

Background: The vast majority of patients with peritonsillar abscess (PTA) recover uneventfully on abscess drainage and antibiotic therapy. However, occasionally patient´s condition deteriorates as the infection spread in the upper airway mucosa, through cervical tissues, or hematogenously. The bacterial etiology of PTA is unclarified and the preferred antimicrobial regimen remains controversial. Read More

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Distribution of descending necrotizing mediastinitis and efficacy of distribution-specific drainage.

J Thorac Dis 2020 May;12(5):2380-2387

Division of Chest Surgery, Department of Surgery, Aichi Medical University, Nagakute, Japan.

Background: Descending necrotizing mediastinitis (DNM) resulting from oropharyngeal and cervical abscess is a life-threatening condition. This study attempted to improve our recognition of the extension and distribution of the abscess for ideal thoracic drainage.

Methods: We performed a retrospective clinical analysis of seven patients who underwent thoracic drainage for DNM with available clinical data. Read More

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Descending Necrotizing Mediastinitis: Analysis of 9 Cases in Our Hospital.

Ear Nose Throat J 2020 Jul 5:145561320933964. Epub 2020 Jul 5.

Department of Otolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

Objectives: Descending necrotizing mediastinitis (DNM) is a serious and progressive infection involving the neck and chest and with high mortality if not treated quickly and properly. The aim of this study is to share our practices for managing this condition.

Methods: We retrospectively evaluated 9 patients diagnosed with DNM in our hospital between January 2006 and October 2019. Read More

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Renal salvage, an achievable goal in patients with emphysematous pyelonephritis: Outcomes of an algorithmic renal preserving strategy.

Urol Ann 2020 Apr-Jun;12(2):156-162. Epub 2020 Apr 14.

Department of Community Medicine, Kasturba Medical College, Mangalore, MAHE, Manipal, Karnataka, India.

Introduction: Emergency nephrectomy has been the time-honored treatment of choice for emphysematous pyelonephritis (EPN), a fatal gas-forming necrotizing infection. Recent years have seen a shift toward nonextirpative approach aimed to achieve higher rates of renal salvage, limiting the indications for nephrectomy to severe grades of the disease. This study aimed at analyzing the role of initial renal preserving measures algorithmically applied across grades of EPN. Read More

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Complicated case of patient with cervical necrotising fasciitis and descending necrotizing mediastinitis case report.

Rozhl Chir 2020 ;99(4):189-193

Descending necrotizing mediastinitis is a severe, fulminant, life-threatening bacterial infection of the mediastinum. Even though improvements in diagnostics and treatment were achieved, the mortality rate remain shigh. Contrast-enhanced CT of chest and neck is the diagnostic gold standard. Read More

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September 2020

Retropharyngeal Abscess. Clinical Review of Twenty-five Years.

Acta Otorrinolaringol Esp 2021 Mar-Apr;72(2):71-79. Epub 2020 May 30.

Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, España.

Introduction: Retropharyngeal abscess is a serious condition. Its rare occurrence, thus sharing symptoms with other processes, make it a diagnostic challenge for the clinician. Therefore, it is critical to make an early diagnosis to prevent delaying treatment and avoid complications. Read More

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Clinical features and management of post-necrotizing enterocolitis strictures in infants: A multicentre retrospective study.

Medicine (Baltimore) 2020 May;99(19):e20209

Department of Neonatal Surgery Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders (Chongqing) China International Science and Technology Cooperation base of Child development and Critical Disorders Chongqing Key Laboratory of Pediatrics.

To explore the clinical features and management of post-necrotizing enterocolitis strictures.Clinical data from 158 patients with post-necrotizing enterocolitis strictures were summarized retrospectively in 4 academic pediatric surgical centers between April 2014 and January 2019. All patients were treated conservatively in the internal medicine department. Read More

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Giant Thrombosis at Left Anterior Descending Artery Aneurysm in a 10-Year Old Boy with Granulomatosis with Polyangiitis.

Case Rep Cardiol 2020 19;2020:3417910. Epub 2020 Apr 19.

Department of Pediatrics, Tehran University of Medical Science, Tehran, Iran.

Granulomatosis with polyangiitis (GPA), necrotizing vasculitis of small and medium-sized vessels, is traditionally believed to mainly affect respiratory tract with additional focal kidney involvements as its primary manifestations with a relatively rare annual incidence rate of 20-50 cases per million. Six percent of the affected cases have cardiac involvements; among which, aneurysms comprise the lowest penetrance. By this paper, we aim to cast light on clinical diagnostic and treatment methods of a rare case presentation, a 10-year-old male GPA patient, diagnosed with massive thrombosis at his coronary artery aneurysm. Read More

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Necrotizing fasciitis of the entire head and neck: Literature review and case report.

Biomed J 2020 02 27;43(1):94-98. Epub 2020 Feb 27.

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address:

Necrotizing fasciitis (NF) is uncommon but potentially lethal when it is associated with systemic disorders. We report a case of odontogenic NF in a patient with uncontrolled diabetes mellitus. The patient was referred on day 10 since the onset of odontogenic NF. Read More

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February 2020

A multidisciplinary approach to the management of descending necrotizing mediastinitis - case series.

Neuro Endocrinol Lett 2019 Dec;40(6):284-288

Department of Anaesthesiology and Intensive Care, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital in Martin, Slovakia.

Objectives: Descending necrotizing mediastinitis (DNM) is a severe potentially fatal disease of the mediastinum which spreads downwards from oropharyngeal region. Mortality varies from 11 to 40%. There is agreement on the importance of early diagnosis, aggressive surgical treatment and the need for a multidisciplinary approach. Read More

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December 2019