Descending necrotizing mediastinitis in the elderly patients

doi:10.1515/med-2016-0080

. 2016 Nov 19;11(1):449-460.

doi: 10.1515/med-2016-0080. eCollection 2016.

Descending necrotizing mediastinitis in the elderly patients

Affiliations

¹ Thoracic Surgery Unit, Second University of Naples, Italy.
² Maxillo-Facial Surgery Unit, Second University of Naples, Italy.
³ Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy.
⁴ Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Naples, Italy.
⁵ Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Italy.
⁶ Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Piazza Miraglia, 2, 80138 Naples, Italy.

PMID: 28352835
PMCID: PMC5329867
DOI: 10.1515/med-2016-0080

Descending necrotizing mediastinitis in the elderly patients

Antonio Mazzella et al. Open Med (Wars). 2016.

. 2016 Nov 19;11(1):449-460.

doi: 10.1515/med-2016-0080. eCollection 2016.

Affiliations

¹ Thoracic Surgery Unit, Second University of Naples, Italy.
² Maxillo-Facial Surgery Unit, Second University of Naples, Italy.
³ Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy.
⁴ Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Naples, Italy.
⁵ Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Italy.
⁶ Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Piazza Miraglia, 2, 80138 Naples, Italy.

PMID: 28352835
PMCID: PMC5329867
DOI: 10.1515/med-2016-0080

Abstract

Descending Necrotizing Mediastinitis (DNM) is a polymicrobic, dangerous and often fatal process, arising from head or neck infections and spreading along the deep fascial cervical planes, descending into the mediastinum. It can rapidly progress to sepsis and can frequently lead to death. It has a high mortality rate, up to 40% in the different series, as described in the literature. Surgical and therapeutic management has been discussed for long time especially in an elderly patient population. The literature has been reviewed in order to evaluate different pathogenesis and evolution and to recognise a correct therapeutic management.

Keywords: Descending necrotizing mediastinitis; Head and neck infection; Management.

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Conflict of interest statement

Conflict of Interests: The authors declare that they have no conflict of interests.

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References

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1. Singhal P, Kejriwal N, Lin Z, Tsutsui R, Ullal R.. Optimal surgical management of descending necrotising mediastinitis: our experience and review of literature. Heart Lung Circ. 2008;17:124–128. - PubMed
1. De Freitas RP, Fahy CP, Brooker DS, Primrose WJ, McManus KG, McGuigan JA, Hughes SJ.. Descending necrotising mediastinitis: a safe treatment algorithm. Eur Arch Otorhinolaryngol. 2007;264:181–187. - PubMed
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[1] Papalia E, Rena O, Oliaro A, Cavallo A, Giobbe R, Casadio C, Maggi G, Mancuso M.. Descending necrotizing mediastinitis: surgical management. Eur J Cardiothorac Surg. 2001;20:739–742. - PubMed

[2] Papalia E, Rena O, Oliaro A, Cavallo A, Giobbe R, Casadio C, Maggi G, Mancuso M.. Descending necrotizing mediastinitis: surgical management. Eur J Cardiothorac Surg. 2001;20:739–742. - PubMed

[3] Mihos P, Potaris K, Gakidis I, Papadakis D, Rallis G.. Managementof descending necrotizing mediastinitis. J Oral Maxillofac Surg. 2004;62:966–972. - PubMed

[4] Mihos P, Potaris K, Gakidis I, Papadakis D, Rallis G.. Managementof descending necrotizing mediastinitis. J Oral Maxillofac Surg. 2004;62:966–972. - PubMed

[5] Singhal P, Kejriwal N, Lin Z, Tsutsui R, Ullal R.. Optimal surgical management of descending necrotising mediastinitis: our experience and review of literature. Heart Lung Circ. 2008;17:124–128. - PubMed

[6] Singhal P, Kejriwal N, Lin Z, Tsutsui R, Ullal R.. Optimal surgical management of descending necrotising mediastinitis: our experience and review of literature. Heart Lung Circ. 2008;17:124–128. - PubMed

[7] De Freitas RP, Fahy CP, Brooker DS, Primrose WJ, McManus KG, McGuigan JA, Hughes SJ.. Descending necrotising mediastinitis: a safe treatment algorithm. Eur Arch Otorhinolaryngol. 2007;264:181–187. - PubMed

[8] De Freitas RP, Fahy CP, Brooker DS, Primrose WJ, McManus KG, McGuigan JA, Hughes SJ.. Descending necrotising mediastinitis: a safe treatment algorithm. Eur Arch Otorhinolaryngol. 2007;264:181–187. - PubMed

[9] Zabaleta J, Aguinagalde B, Izquierdo JM, Hernández CJ.. Acute mediastinitis as a complication of H1N1 influenza. Arch Bronconeumol. 2010;46(7):398. Jul. - PubMed

[10] Zabaleta J, Aguinagalde B, Izquierdo JM, Hernández CJ.. Acute mediastinitis as a complication of H1N1 influenza. Arch Bronconeumol. 2010;46(7):398. Jul. - PubMed

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Descending necrotizing mediastinitis in the elderly patients

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Descending necrotizing mediastinitis in the elderly patients

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