Descending necrotizing mediastinitis: trends in a developing country.
Descending necrotizing mediastinitis is believed to be a rare and serious complication of odontogenic and oropharyngeal infections. It is associated with a high (up to 40%) mortality rate, which can be attributed to delays in diagnosis and inadequate surgical drainage. Between May 1999 and September 2002, we treated 7 cases at our institution in New Delhi, indicating that such fulminating infections are not so rare in developing countries. In our 7 cases, a high index of suspicion and early computed tomography helped us make a rapid diagnosis and initiate prompt treatment, which resulted in a favorable outcome in 6 cases (mortality rate: 14.3%).
Chaudhary
Neena
N
Department of Otolaryngology, Safdarjung Hospital, New Delhi. neena_ent@yahoo.com
Agrawal
Sanjay
S
Rai
Anil K
AK
D000038:Abscess / Q000150:complications / Q000382:microbiology / Q000473:pathology; D000328:Adult; D001424:Bacterial Infections / Q000150:complications; D002391:Catchment Area, Health; D003906:Developing Countries; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008478:Mediastinal Emphysema / Q000453:epidemiology; D008480:Mediastinitis / Q000453:epidemiology* / Q000382:microbiology / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis; D010996:Pleural Effusion / Q000382:microbiology; D011300:Preoperative Care; D015995:Prevalence; D014076:Tooth Diseases / Q000150:complications / Q000401:mortality / Q000473:pathology