Cervical necrotizing fasciitis and descending necrotizing mediastinitis in a patient affected by neglected peritonsillar abscess: a case of medical negligence.
We report a case of fatal cervical necrotizing fasciitis (CNF) and descending necrotizing mediastinitis (DNM) due to primary peritonsillar abscess in 60-year-old male patient with no history or evidence of immunocompromising disorders. The patient was treated with antibiotic and corticosteroid drugs but he developed mediastinitis and septic shock and died of multiple organ failure six days later from recovery in hospital. After a clinical, diagnostic and therapeutical consideration of the cervical necrotizing fasciitis and some related risks of a delayed diagnosis and treatment, the authors analysed the clinical history of the patient and of the medical conduct pointing out professional malpractice chargeable to doctors.
Bono
Giovanna
G
Department of Legal Medicine, University of Palermo, Via Del Vespro, 127-90129 Palermo, Italy. giovanna.bono@infinito.it
Argo
Antonina
A
Zerbo
Stefania
S
Triolo
Valentina
V
Procaccianti
Paolo
P
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019115:Fasciitis, Necrotizing / Q000188:drug therapy / Q000209:etiology*; D017809:Fatal Outcome; D049429:Forensic Pathology; D006801:Humans; D007558:Italy; D008206:Lymphatic Diseases / Q000209:etiology; D008297:Male; D008318:Malpractice; D008480:Mediastinitis / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D000039:Peritonsillar Abscess / Q000150:complications*
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents