The Spread of Infection through the Danger Zone in to the Mediastinum
Authors:
D. Schlenkerová 1; K. Mlčáková 2; P. Hanzel 2; V. Mikulášová 2; A. Hajtman 1
Authors‘ workplace:
ORL klinika, Fakultná nemocnica Trenčín
1; Klinika ORL a ChHaK UK JLF a UNM, Martin
2
Published in:
Otorinolaryngol Foniatr, 63, 2014, No. 1, pp. 29-31.
Category:
Case History
Overview
Deep neck infection is an infection in the neck area and the fascial layer with formation of abscess or cellulitis collections (4). Cervical fascia creates a space plane, which defines and limits the spread of infection. Danger zone is the area of thin connective tissue extending from the skull base down to the diaphragm. This space is enclosed on all sides, so that there arises in penetration of infection inflammation of the surrounding areas (2, 3). Hazard lies in the rapid spread of infection in the chest, which is due to the low resistance of thin connective tissue (2). The most common and most feared complication of inflammation in the danger space is the formation of the descending necrotizing mediastinitis (DNM). Authors describe a case of extensive dental infection that despite intensive surgical and antibiotic treatment spread to other anatomical areas and caused descending necrotizing mediastinitis.
Keywords:
danger space, deep neck infection, descendent necrotizing mediastinitis
Sources
1. Kang, S. K., Lee, S., Kong O. H. H., Kang, M. W., Hoon N. A. M., Hyeon Y. U. J., Seok Koo, B., Pyung Lim, S.: Clinical features of deep neck infections and predisposing factors for mediastinal extension. The Korean Journal of Thoracic and Cardiovascular surgery, 7, 2012, s. 171-176.
2. Vieira, F., Allen, S. M., Stock, R. M. S., Thompson J. W.: Deep neck infection. Otolaryngologic Clinics of North America, 41, 2008, s. 459-483
3. Som, P. M., Curtin, H. D.: Fascia and spaces of the neck. Head and Neck Imaging, St. Luis, 2003, s. 1805-1827.
4. Komínek, P., Chrobok, V., Astl, J. a kolektiv: Záněty hltanu. 1. vyd., Havlíčkúv Brod, Tobiáš, 2005, s. 251-256.
5. Endo, S., Murayama, F., Hasegava, T., Yamamoto, S., Yamaguchii, T., Sohara, Y., Fuse, K., Miyata, M., Nishino: Guideline of surgical management based on diffusion of descending necrotizing mediastinitis. The Japanese Journal of Thoracic and Cardiovascular Surgery, 47, 1999, s. 14-19.
6. Banazedeh, M., Eshraghi, M., Bagher, R. M., Asghar, A. A., Kord, V.: Succesful management of acute necrotizing mediastinitis with trans-cervical drainage. Annals of Thoracic and Cardiovascular Surgery, 17, 2011, s. 498-500.
7. PInto, A., Scaglione, M., Scuderi, M. G., Tortora, G., Daniele, S., Romano, L.: Infections of the neck leading to descending necrotizing mediastinitis: Role of multi-detector row computed tomography. European Journal of Radiology, 65, 2008, s. 389-394.
8. Ho, K. L. Chen, H. L. , Lin, Ch. M.: Acute descending mediastinitis secondary to an odontogenic infection in a pacient initially suspected of having acute thyroiditis. A case report. King Liang Ho, H. L. Chen, Ch. M. Lin. Journal of Acute Medicíně, 1, 2011, s. 52-54.
9. Yang, S. W., Lee, M. H., Lee, Y. S., Huang, S. H., Chen, T. A., Fang, T. J.: Analysis of life-threatening complications od deep neck abscess and the impact of empiric antibiotics. Otorinolaryngology, 70, 2008, 4, s. 249-256.
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Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
2014 Issue 1
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