Servikal nekrotizan fasiite sekonder desendan nekrotizan mediastenit: İki olgu sunumu ve güncel literatür

Servikal nekrotizan fasiit, daha çok yaşlılarda ve immün yetmezliği bulunan hastalarda görülen, polimikrobiyal kökenli, hızlı ve yıkıcı seyreden ve bazen ölümcül olabilen bir derin boyun enfeksiyonudur. Nadiren enfeksiyon derin fasiyal planlar aracılığı ile mediastene yayılır ve desendan nekrotizan mediastenite neden olur. Desendan nekrotizan mediastinit yüksek mortaliteye sahip, acilen tanı konulup tedavi edilmesi gereken ciddi bir tablodur. Bu derlemede biri tip 1, diğeri de tip 2B desendan nekrotizan mediastinit tanısı ile servikal ve mediastinal drenaj ile tedavi edilmiş iki olgu sunuldu ve konu ile ilgili güncel literatür tartışıldı

Descending necrotizing mediastinitis secondary to cervical necrotizing fasciitis: Two case reports and contemporary literature

Cervical necrotizing fasciitis is a polymicrobial, rapidly progressive, destructive, and sometimes fatal deep neck infection, that is most commonly seen in the elderly and immunocompromised patients. The infection rarely spreads to mediastina via deep fascial planes and causes descending necrotizing mediastinitis. Descending necrotizing mediastinitis is a serious clinical entity with a high mortality rate that should be promptly diagnosed and treated. In this review, we present two cases with type 1 and type 2B descending necrotizing mediastinitis treated with servical and mediastinal drainage, and also discuss relevant contemporary literature.

___

  • Langford FP, Moon RE, Stolp BW, Scher RL. Treatment of cervical necrotizing fasciitis with hyperbaric oxygen therapy. Otolaryngol Head Neck Surg 1995;112:274-8.
  • Sumi Y. Descending necrotizing mediastinitis: 5 years of published data in Japan. Acute Medicine & Surgery 2015;2:1-12.
  • Deu-Martín M, Saez-Barba M, López Sanz I, Alcaraz Peñarrocha R, Romero Vielva L, Solé Montserrat J. Mortality risk factors in descending necrotizing mediastinitis. Arch Bronconeumol 2010;46:182-7. [Abstract]
  • Roccia F, Pecorari GC, Oliaro A, Passet E, Rossi P, Nadalin J, et al. Ten years of descending necrotizing mediastinitis: management of 23 cases. J Oral Maxillofac Surg 2007;65:1716-24.
  • Misthos P, Katsaragakis S, Kakaris S, Theodorou D, Skottis I. Descending necrotizing anterior mediastinitis: analysis of survival and surgical treatment modalities. J Oral Maxillofac Surg 2007;65:635-9.
  • Moncada R, Warpeha R, Pickleman J, Spak M, Cardoso M, Berkow A, et al. Mediastinitis from odontogenic and deep cervical infection. Anatomic pathways of propagation. Chest 1978;73:497-500.
  • Sarna T, Sengupta T, Miloro M, Kolokythas A. Cervical necrotizing fasciitis with descending mediastinitis: literature review and case report. J Oral Maxillofac Surg 2012;70:1342-50.
  • Sumi Y, Ogura H, Nakamori Y, Ukai I, Tasaki O, Kuwagata Y, et al. Nonoperative catheter management for cervical necrotizing fasciitis with and without descending necrotizing mediastinitis. Arch Otolaryngol Head Neck Surg 2008;134:750-6.
  • Liem-Nguyen V, Bouchet S, Björn E. Determination of sub-nanomolar levels of low molecular mass thiols in natural waters by liquid chromatography tandem mass spectrometry after derivatization with p-(hydroxymercuri) benzoate and online preconcentration. Anal Chem 2015;87:1089-96.
  • Shumrick KA, Sheft SA, et al. Deep neck infections. In: Paparella MM, Shumrick DA, Gluckman JL, et al., editors. Otolaryngology 3rd Ed. Philadelphia: WB Saunders Philadelphia 1990; 2545-63.
  • Pearse HE. Mediastinitis following cervical suppuration. Ann Surg 1938;108:588-611.
  • Freeman RK, Vallières E, Verrier ED, Karmy-Jones R, Wood DE. Descending necrotizing mediastinitis: An analysis of the effects of serial surgical debridement on patient mortality. J Thorac Cardiovasc Surg 2000;119:260-7.
  • Lin C, Yeh FL, Lin JT, Ma H, Hwang CH, Shen BH, et al. Necrotizing fasciitis of the head and neck: an analysis of 47 cases. Plast Reconstr Surg 2001;107:1684-93.
  • Mohammedi I, Ceruse P, Duperret S, Vedrinne J, Boulétreau P. Cervical necrotizing fasciitis: 10 years' experience at a single institution. Intensive Care Med 1999;25:829-34.
  • Bahu SJ, Shibuya TY, Meleca RJ, Mathog RH, Yoo GH, Stachler RJ, et al. Craniocervical necrotizing fasciitis: an 11-year experience. Otolaryngol Head Neck Surg 2001;125:245-52.
  • Krenk L, Nielsen HU, Christensen ME. Necrotizing fasciitis in the head and neck region: an analysis of standard treatment effectiveness. Eur Arch Otorhinolaryngol 2007;264:917-22.
  • Papalia E, Rena O, Oliaro A, Cavallo A, Giobbe R, Casadio C, et al. Descending necrotizing mediastinitis: surgical management. Eur J Cardiothorac Surg 2001;20:739-42.
  • Karkas A, Chahine K, Schmerber S, Brichon PY, Righini CA. Optimal treatment of cervical necrotizing fasciitis associated with descending necrotizing mediastinitis. Br J Surg 2010;97:609-15.
  • Guan X, Zhang WJ, Liang X, Liang X, Wang F, Guo X, et al. Optimal surgical options for descending necrotizing mediastinitis of the anterior mediastinum. Cell Biochem Biophys 2014;70:109-14.
  • Estrera AS, Landay MJ, Grisham JM, Sinn DP, Platt MR. Descending necrotizing mediastinitis. Surg Gynecol Obstet 1983;157:545-52.
  • Wheatley MJ, Stirling MC, Kirsh MM, Gago O, Orringer MB. Descending necrotizing mediastinitis: transcervical drainage is not enough. Ann Thorac Surg 1990;49:780-4.
  • Hsin MK, Yim AP. Video assisted thoracoscopic surgery is a valuable approach for the management of descending necrotizing mediastinitis. Ann Surg 2011;253:1055.
  • Stella F, Petrella F. Transsternal transpericardial approach for acute descending necrotizing mediastinitis. J Thorac Cardiovasc Surg 2005;129:212-4.
  • Tanaka Y, Maniwa Y, Yoshimura M, Okita Y. Successful treatment of descending necrotizing mediastinitis. Gen Thorac Cardiovasc Surg 2007;55:366-9.
  • Ris HB, Banic A, Furrer M, Caversaccio M, Cerny A, Zbären P. Descending necrotizing mediastinitis: surgical treatment via clamshell approach. Ann Thorac Surg 1996;62:1650-4.
  • Endo S, Murayama F, Hasegawa T, Yamamoto S, Yamaguchi T, Sohara Y, et al. Guideline of surgical management based on diffusion of descending necrotizing mediastinitis. Jpn J Thorac Cardiovasc Surg 1999;47:14-9.
  • Min HK, Choi YS, Shim YM, Sohn YI, Kim J. Descending necrotizing mediastinitis: a minimally invasive approach using video-assisted thoracoscopic surgery. Ann Thorac Surg 2004;77:306-10.
  • Corsten MJ, Shamji FM, Odell PF, Frederico JA, Laframboise GG, Reid KR, et al. Optimal treatment of descending necrotising mediastinitis. Thorax 1997;52:702-8.
  • Marty-Ane CH, Alauzen M, Alric P, Serres-Cousine O, Mary H. Descending necrotizing mediastinitis. Advantage of mediastinal drainage with thoracotomy. J Thorac Cardiovasc Surg 1994;107:55-61.
  • Mathieu D, Neviere R, Teillon C, Chagnon JL, Lebleu N, Wattel F. Cervical necrotizing fasciitis: clinical manifestations and management. Clin Infect Dis 1995;21:51-6.
  • Skitarelić N, Mladina R, Morović M, Skitarelić N. Cervical necrotizing fasciitis: sources and outcomes. Infection 2003;31:39-44.