Immunocompromised and descending necrotizing mediastinitis: case report

ANNA CAROLINA JACCOTTET OLIVEIRA, NATASHA MAGRO ERNICA, RICARDO AUGUSTO CONCI, GERALDO LUIZ GRIZA, ELEONOR ÁLVARO GARBIN JÚNIOR

Introduction: The descending necrotizing mediastinitis (DNM) is caused by an odontogenic infection that invades facial and cervical spaces and reaches the mediastinum. Sometimes the signals and primary symptoms can be discrete, however, it cannot be underestimated. Objective: The present work aims to relate a clinical case of DNM originated from a dental abscess of the tooth #37. Case report: The patient affected by the infection is a 43 years old, male, diabetic, hypertensive, alcoholist and smoker. He was admitted in the hospital with invasive odontogenic infection with several facial and cervical spaces. Clinically, he showed extraoral necrosis and active fistulisation in certain regions. After physical and imagiologic exams, through computed tomography scan, the DNM was diagnosed. In view of such diagnosis, the antibiotic therapy was started along with the drainage and debride- ment of the affected regions. This procedure was realized with the General Surgery team. The patient remained in the Intensive Care Unit after the surgery being under antibiotic therapy and systemic conditions control. Results and Conclusion: Due to the aggressive surgical treat- ment associated to the antibiotic therapy and the sys- temic conditions control, it was possible to achieve success on the treatment.

Keywords: Mediastinitis. Infection. Drainage. Diabetes mellitus. Alcoholism.

How to cite: Oliveira ACJ, Ernica NM, Conci RA, Griza GL, Garbin Júnior EA. Immunocompromised and descending necrotizing mediastinitis: case report. J Braz Coll Oral Maxillofac Surg. 2020 May-Aug;6(2):44-9.

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