Cervical necrotising fasciitis and descending mediastinitis secondary to unilateral tonsillitis: A case report

被引：11

作者：

Islam A. ^{[1
]}

Oko M. ^{[1
]}

机构：

[1] Pilgrim Hospital, Boston, Lincolnshire PE21 9QS, Sibsey Road

来源：

Journal of Medical Case Reports | / 2卷 / 1期

关键词：

Computerise Tomography; Necrotizing Fasciitis; Mediastinitis; Percutaneous Catheter Drainage; Peritonsillar Abscess;

D O I：

10.1186/1752-1947-2-368

中图分类号：

学科分类号：

摘要：

Introduction: Cervical necrotizing fasciitis is an aggressive infection with high morbidity and mortality. We present a case of cervical necrotizing fasciitis and descending mediastinitis in a healthy young man, caused by unilateral tonsillitis with a successful outcome without aggressive debridement. Case presentation: A 41-year-old man was admitted to our unit with a diagnosis of severe acute unilateral tonsillitis. On admission, he had painful neck movements and the skin over his neck was red, hot and tender. Computed tomography scan of his neck and chest showed evidence of cervical necrotizing fasciitis and descending mediastinitis secondary to underlying pharyngeal disease. He was treated with broad-spectrum intravenous antibiotics. His condition improved over the next 3 days but a tender and fluctuant swelling appeared in the suprasternal region. A repeat scan showed the appearance of an abscess extending from the pretracheal region to the upper mediastinum which was drained through a small transverse anterior neck incision. After surgery, the patient's condition quickly improved and he was discharged on the 18th day of admission. Conclusion: Less invasive surgical techniques may replace conventional aggressive debridement as the treatment of choice for cervical necrotizing fasciitis and descending necrotizing mediastinitis. © 2008 Islam and Oko; licensee BioMed Central Ltd.

引用

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