<abstract xml:lang="en" xmlns="http://www.w3.org/1999/xhtml"><bold>Background.</bold> Although odontogenic infections are relatively frequent in the general population, intrathoracic dissemination is a rare complication. Acute purulent mediastinitis, known as descending necrotizing mediastinitis (DNM), causes high mortality rate, even up to 40%, despite high efficacy of antibiotic therapy and surgical interventions. In rare cases, unilateral or bilateral pleural empyema develops as a complication of DNM.<bold>Case report.</bold> This case report presents the treatment of a young, previously healthy patient with mediastinitis and bilateral pleural empyema caused by an odontogenic infection. After a neck and pharynx re-incision, and as CT confirmed propagation of the abscess to the thorax, thoracotomy was performed followed by CT-controlled thoracic drainage with continued antibiotic therapy. The patient was cured, although the recognition of these complications was relatively delayed.<bold>Conclusions.</bold> Early diagnosis of DNM can save the patient, so if this severe complication is suspected, thoracic CT should be performed.</abstract>

Background. Although odontogenic infections are relatively frequent in the general population, intrathoracic dissemination is a rare complication. Acute purulent mediastinitis, known as descending necrotizing mediastinitis (DNM), causes high mortality rate, even up to 40%, despite high efficacy of antibiotic therapy and surgical interventions. In rare cases, unilateral or bilateral pleural empyema develops as a complication of DNM.Case report. This case report presents the treatment of a young, previously healthy patient with mediastinitis and bilateral pleural empyema caused by an odontogenic infection. After a neck and pharynx re-incision, and as CT confirmed propagation of the abscess to the thorax, thoracotomy was performed followed by CT-controlled thoracic drainage with continued antibiotic therapy. The patient was cured, although the recognition of these complications was relatively delayed.Conclusions. Early diagnosis of DNM can save the patient, so if this severe complication is suspected, thoracic CT should be performed.

Mediastinitis and bilateral pleural empyema caused by an odontogenic infection

Clinic for Oral and Maxillofacial Surgery, Clinical hospital, Rijeka, Croatia

Clinic for Anaesthesiology and Reanimatology, Clinical hospital, Rijeka, Croatia

Department of Radiology, Clinical hospital, Rijeka, Croatia

Clinic for Internal Medicine, Clinical hospital, Rijeka, Croatia

Radiology and Oncology

{"article-title":"Mediastinitis and bilateral pleural empyema caused by an odontogenic infection"}

Background. Although odontogenic infections are relatively frequent in the general population, intrathoracic dissemination is a rare complication. Acute...

Mediastinitis and bilateral pleural empyema caused by an odontogenic infection

Pubblicato online: 06 ago 2007

Pagine: 57 - 62

DOI: https://doi.org/10.2478/v10019-007-0010-0

Parole chiave
mediastinitis, empyema, pleural, periapical abscess, complications

This content is open access.

Mediastinitis and bilateral pleural empyema caused by an odontogenic infection

Pubblicato online: 06 ago 2007

Pagine: 57 - 62

DOI: https://doi.org/10.2478/v10019-007-0010-0

Parole chiavemediastinitis, empyema, pleural, periapical abscess, complications

This content is open access.

Parole chiave
mediastinitis, empyema, pleural, periapical abscess, complications