[Mediastinitis and cervical fasciitis necroticans post extraction of 2 molars].
A 38-year-old man developed dysphagia, fever and marked trismus, resulting in an abcess of the parafaryngeal region, soon after the surgical extraction of 2 mandibular molars. Despite systemic antibiotics and surgical drainage, the abcess spread to the mediastinum. Within a short space of time, cervical fasciitis necroticans and descending necrotizing mediastinitis developed. Because of the life-threatening health condition, the patient was admitted to a hospital for further treatment. He underwent surgical exploration of the cervical and sternal region, thoracotomy for mediastinal drainage, debridement, and daily mediastinal rinsing with hydrogen peroxide and betadine iodine. After 5 weeks intensive treatment, the patient could be discharged from the hospital in a fairly good condition of health.
Zijderveld
S A
SA
St. Antonius Ziekenhuis te Nieuwegein. s.zijderveld@antonius.net
van Swieten
H A
HA
Frenken
J W F H
JW
Yilmaz
A
A
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004322:Drainage / Q000379:methods*; D019115:Fasciitis, Necrotizing / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D013908:Thoracotomy / Q000379:methods; D014081:Tooth Extraction / Q000009:adverse effects*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents