Anaerobic mediastinitis.
Three patients with anaerobic mediastinitis associated with retropharyngeal abscess have been encountered recently. Dental infections accounted for two instances, and the third instance resulted from rupture of the thoracic esophagus from blunt trauma. Each was marked by extreme difficulty in achieving complete abscess drainage due to the initially unrecognized virulence of the causative anaerobic bacteria. Complications were frequent and included empyema, pericarditis and aspiration pneumonia. The combination of vigorous diagnostic efforts, prompt operation and reoperation when necessary plus specific antibiotic effective against anaerobes led to a successful outcome for each patient.
D000038:Abscess / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D000693:Anaerobiosis; D001424:Bacterial Infections / Q000000981:diagnostic imaging*; D001442:Bacteroides Infections / Q000000981:diagnostic imaging; D001441:Bacteroides fragilis / Q000302:isolation & purification; D004322:Drainage; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000150:complications; D008480:Mediastinitis / Q000000981:diagnostic imaging*; D008826:Microbial Sensitivity Tests; D010493:Pericarditis / Q000000981:diagnostic imaging; D010608:Pharyngeal Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D010996:Pleural Effusion / Q000000981:diagnostic imaging; D011552:Pseudomonas Infections / Q000000981:diagnostic imaging; D011859:Radiography; D013290:Streptococcal Infections / Q000150:complications