Descending necrotizing mediastinitis caused by Streptococcus constellatus: A case report and review of the literature.
Medicine (Baltimore)
; 102(14): e33458, 2023 Apr 07.
Article
en En
| MEDLINE
| ID: mdl-37026905
ABSTRACT
RATIONALE Descending necrotizing mediastinitis (DNM) is a rare but severe mediastinal infection. If not diagnosed and treated promptly, the consequences can be very serious. Here, we shared a successful diagnosis and treatment case of DNM that originates from oral to neck and mediastinum caused by Streptococcus constellatus (S constellatus). S constellatus is a clinically uncommon gram-positive coccus and is known for its ability to form abscesses. Timely surgical drainage and the correct use of antibiotics are key to successful treatment. PATIENT CONCERNS A 53-year-old male admitted to hospital with painful swelling of the right cheek, persistent oral pus and moderate fever lasting 1 week, followed by rapid development of a mediastinal abscess. DIAGNOSES He was diagnosed with DNM caused by S constellatus. INTERVENTIONS:
On the evening of admission, an emergency tracheotomy and thoracoscopic exploration and drainage of the right mediastinum, floor of the mouth, parapharynx and neck abscess were performed. Antibiotics were administered immediately.OUTCOMES:
At 28 days post-operatively, the abscess was absorbed, bilateral lung exudate decreased and the patient temperature, aspartate transaminase, alanine transaminase, bilirubin and platelets returned to normal. The patient was discharged after completing 4 weeks of antibiotic therapy. Follow-up at 3 months after discharge revealed no recurrence of the abscess. LESSONS Early surgical drainage and antibiotics treatment are important in mediastinal abscesses and infectious shock due to Streptococcus asteroids.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Streptococcus constellatus
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Mediastinitis
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Enfermedades del Mediastino
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
Límite:
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Medicine (Baltimore)
Año:
2023
Tipo del documento:
Article
País de afiliación:
China