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Publication year
2009Source
Nederlands Tijdschrift voor Geneeskunde, 153, (2009), pp. B364ISSN
Publication type
Article / Letter to editor
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Organization
Cardio Thoracic Surgery
Otorhinolaryngology
Oral and Maxillofacial Surgery
Former Organization
Thoracic Cardiac Surgery
Journal title
Nederlands Tijdschrift voor Geneeskunde
Volume
vol. 153
Page start
p. B364
Page end
p. B364
Subject
NCEBP 2: Evaluation of complex medical interventions; NCEBP 4: Quality of hospital and integrated care; ONCOL 3: Translational researchAbstract
Three patients developed descending necrotizing mediastinitis (DNM): a 44-year-old man due to poor dental status; a 54-year-old women due to a throat infection, 6 weeks after a tooth extraction; and a 30-year-old man a few days after a tooth extraction. Presenting symptoms were dyspnoea, fever, trismus, cervical oedema, and pain. The first two patients had multiple drainage of the cervical region and mediastinum in combination with pathogen-specific antibiotics. Both recovered without any complications. The third patient probably had inadequate surgical drainage of the mediastinum directly after diagnosis, and died. If the CT scan is suggestive of DNM, the patient should be referred to a thoracic surgical unit immediately. The optimal treatment consists of vigorous surgical drainage of both the neck and mediastinum with irrigation in combination with pathogen-specific antibiotic therapy. An early diagnosis followed by adequate antibiotic and surgical treatment improves the outcome in patients with DNM.
This item appears in the following Collection(s)
- Academic publications [238441]
- Electronic publications [122542]
- Faculty of Medical Sciences [90373]
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