Descending Necrotizing Mediastinitis in Healthy Young Adults: The Fatal Consequence of the Delayed Help
Abstract
:1. Introduction
2. Case Series Presentation
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient | 1 | 2 | 3 | 4 |
---|---|---|---|---|
Sex/age | 23/male | 31/male | 32/male | 33/male |
Toothache | - | - | - | + * |
Submandibular pain | + * | + * | + * | + |
Submandibular swelling | + | + | + | + |
Neck pain | + | + | + | + |
Neck swelling | + | + | + | + |
Difficulty swallowing | + | - | + | - |
Difficulty breathing | + | - | - | + |
Fever | + | + | + | + |
Diabetes mellitus | - | - | - | - |
Kidney failure | - | - | - | - |
HIV | - | - | - | - |
Patient | 1 | 2 | 3 | 4 |
---|---|---|---|---|
Neck CT | Pus collection - in the left submandibular area - around the hyoid bone - around the left piriform recessus - around the thyroid cartilage - around the sternocleidomastoid muscle | Presence of a gas collection with delamination of the soft tissues of the neck in the area of the parapharyngeal space on the left Gas collections in - both palatine tonsils - anterior cervical space - left carotid space up to the level of the aortic arch - bilateral submandibular and sublingual space | Multiple air collections that stratify the tissues of the neck on the right side | Multiple air collections that stratify the superficial and deep tissues of the neck and enter the mediastinum |
Chest CT | pus collection: ventral from the thyroid gland measuring 68/14 mm, with a density of 34–40 HU reaching the carina | Purulent collection starting from the neck and reaching the anterior mediastinum above the carina, presence of gas collections | Multiple air collections involving all departments of the anterior mediastinum above the carina | Massive pneumomediastinum, presence of fluid-purulent collections in the anterior and posterior lower mediastinum below the carina |
Surgery | remediating the source of infection and suprasternal mediastinal drainage | Remediating the source of infection and suprasternal mediastinal drainage | Remediating the source of infection and suprasternal mediastinal drainage | Remediating the source of infection and thoracotomy |
Patient | Hemoglobin (120–160) g/L * | Red Blood Cells (3.9–5.3) 1012/L * | White Blood Cells (3.5–10.5) 109 g/L * | Platelets (140–400) 109 L * | Fibrinogen (2.0–4.5) g/L * | C-Reactive Protein (0–10 mg/L) * | Erythrocyte Sedimentation Rate (2–25 mm/h) * |
---|---|---|---|---|---|---|---|
1 | 156 | 4.93 | 17.7 ↑ | 170 | 8.01 ↑ | 113.0 ↑ | 33 ↑ |
2 | 124 | 3.63 ↓ | 24.99 ↑ | 265.0 | 6.81 ↑ | 327.0 ↑ | 70 ↑ |
3 | 110 ↓ | 3.2 ↓ | 1.7 ↓ | 40 ↓ | 7.39 ↑ | 205.0 ↑ | 125 ↑ |
4 | 163 ↑ | 5.67 ↑ | 4.98 | 139.0 | 7.89 ↑ | 362.0 ↑ | 201 ↑ |
Patient | 1 | 2 | 3 | 4 |
---|---|---|---|---|
FiO2 | 0.4 | 0.4 | 0.5 | 0.5 |
PEEP | 8.5 cm H2O | 8 cm H2O | 5 cm H2O | 8 cm H2O |
PS | 14 cm H2O | 13 cm H2O | 10 cm H2O | 9 cm H2O |
MV | 10.5 L/min | 10.5 L/min | 13 L/min | 13 L/min |
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Uchikov, P.; Kraeva, M.; Kraev, K.; Hristov, B.; Chakarov, D.; Ali, N.; Stefanov, C.; Mollova-Kyosebekirova, A.; Tenchev, T.; Dragusheva, S.; et al. Descending Necrotizing Mediastinitis in Healthy Young Adults: The Fatal Consequence of the Delayed Help. Reports 2024, 7, 40. https://doi.org/10.3390/reports7020040
Uchikov P, Kraeva M, Kraev K, Hristov B, Chakarov D, Ali N, Stefanov C, Mollova-Kyosebekirova A, Tenchev T, Dragusheva S, et al. Descending Necrotizing Mediastinitis in Healthy Young Adults: The Fatal Consequence of the Delayed Help. Reports. 2024; 7(2):40. https://doi.org/10.3390/reports7020040
Chicago/Turabian StyleUchikov, Petar, Maria Kraeva, Krasimir Kraev, Bozhidar Hristov, Dzhevdet Chakarov, Nedzhat Ali, Chavdar Stefanov, Angelina Mollova-Kyosebekirova, Tihomir Tenchev, Snezhanka Dragusheva, and et al. 2024. "Descending Necrotizing Mediastinitis in Healthy Young Adults: The Fatal Consequence of the Delayed Help" Reports 7, no. 2: 40. https://doi.org/10.3390/reports7020040
APA StyleUchikov, P., Kraeva, M., Kraev, K., Hristov, B., Chakarov, D., Ali, N., Stefanov, C., Mollova-Kyosebekirova, A., Tenchev, T., Dragusheva, S., Dzhambazova, E., & Dobreva-Yatseva, B. (2024). Descending Necrotizing Mediastinitis in Healthy Young Adults: The Fatal Consequence of the Delayed Help. Reports, 7(2), 40. https://doi.org/10.3390/reports7020040