抜歯後に生じた下行性壊死性縦隔炎の1例
We describe a descending necrotizing mediastinal abscess caused by post-extraction infection that was successfully treated by endoscopic-transthoracic drainage. The patient was 55-year-old man with an odontogenic infection of the oral floor and submandibular region after extraction of the lower seco...
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| Published in | 日本口腔外科学会雑誌 Vol. 58; no. 5; pp. 332 - 336 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
社団法人 日本口腔外科学会
20.05.2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5163 2186-1579 |
| DOI | 10.5794/jjoms.58.332 |
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| Abstract | We describe a descending necrotizing mediastinal abscess caused by post-extraction infection that was successfully treated by endoscopic-transthoracic drainage. The patient was 55-year-old man with an odontogenic infection of the oral floor and submandibular region after extraction of the lower second molar. We performed incisional drainage and administered broad-spectrum antibiotics. Despite treatment the inflammation persisted and formed a deep neck abscess that spread to the mediastinum, resulting in an abscess and subsequent sepsis. Surgical neck drainage for the deep-space neck abscess was performed by an otolaryngologist, and endoscopictransthoracic drainage for the descending necrotizing mediastinal abscess was performed by thoracic surgeons. On bacterial culture, abundant growth of Streptococcus constellatus was disclosed. We gave antibiotics against which the pathogen was sensitive to control the spread of inflammation. Systemic management was performed in an intensive care unit. |
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| AbstractList | We describe a descending necrotizing mediastinal abscess caused by post-extraction infection that was successfully treated by endoscopic-transthoracic drainage. The patient was 55-year-old man with an odontogenic infection of the oral floor and submandibular region after extraction of the lower second molar. We performed incisional drainage and administered broad-spectrum antibiotics. Despite treatment the inflammation persisted and formed a deep neck abscess that spread to the mediastinum, resulting in an abscess and subsequent sepsis. Surgical neck drainage for the deep-space neck abscess was performed by an otolaryngologist, and endoscopictransthoracic drainage for the descending necrotizing mediastinal abscess was performed by thoracic surgeons. On bacterial culture, abundant growth of Streptococcus constellatus was disclosed. We gave antibiotics against which the pathogen was sensitive to control the spread of inflammation. Systemic management was performed in an intensive care unit. |
| Author | 篠原, 正徳 中山, 秀樹 高宗, 康隆 赤崎, 幸太 平木, 昭光 吉武, 義泰 |
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| References | 11) 坂井陳作, 徳永有紀, 他：基礎疾患のない若年者に発生した口底部非クロストリジウム性ガス蜂窩織炎の1例. 日口外誌 46: 599-601, 2000. 15) Paul L Marino : The ICU Book（監訳者：稲田英一）, 第3版, 株式会社メディカル・サイエンス・インターナショナル, 東京都, 2009, 642-647頁. 9) 川真田修, 青山正博, 他：ドレナージにて救命したdescending necrotizing mediastinitis の2例. 日臨外会誌 59: 104-107, 1998. 10) 内山公男, 磯畑祐司, 他：腎透析患者に発生した重篤な歯性感染症の1例. 口科誌 42: 558-561, 1993. 7) 森脇義弘, 吉田謙一, 他：下行性壊死性縦隔炎に対する前方アプローチによる縦隔ドレナージ. 日消外会誌 35: 460-464, 2002. 8) 廣田哲也, 小泉雅英, 他：下縦隔にまで進展したdescending necrotizing mediastinitis の1救命例. 日 救急医会誌 9: 600-604, 1998. 6) Dellinger RP, Levy MM, et al : Surviving Sepsis Campaign :international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 36: 296-327, 2008. 12) Rallis G, Papadakis D, et al : Rare complications of a dental abscess. Gen Dent 54: 44-45, 2006. 14) 原 祐郁, 鈴木光隆：Descending necrotizing mediastinitis の臨床的検討. 日呼外会誌 22: 976-980, 2008. 4) 遠藤邦彦, 市川健司, 他：縦隔炎を併発した歯性感染症の1例. 日口外誌 36: 1060-1065, 1990. 2) 伊藤 聡, 森田悦弥, 他：歯性感染症から進展した頸部蜂巣炎, 縦隔炎の1例. 日口外誌 53: 489-492, 2005. 13) 平林秀樹：口腔咽頭喉頭疾患 深頸部膿瘍. 耳喉頭頸 81: 473-476, 2009. 1) 鹿嶋光司, 黒川英雄, 他：集中治療で救命し得た智歯周囲炎に起因する顔面頸部蜂窩織炎・縦隔炎・両側膿胸の1例. 日口外誌 53: 420-424, 2007. 3) Bonapart IE, Stevens HP, et al : Rare complications of an odontogenic abscess:mediastinitis, thoracic empyema and cardiac tamponade. J Oral Maxillofac Surg 53: 610-613, 1995. 5) Zeitoun IM and Dhanarajani PI : Cervical cellulites and mediastinitis caused by odontogenic infection: Report of two cases and review of literature. J Oral Maxillofac Surg 53: 203-208, 1995. |
| References_xml | – reference: 5) Zeitoun IM and Dhanarajani PI : Cervical cellulites and mediastinitis caused by odontogenic infection: Report of two cases and review of literature. J Oral Maxillofac Surg 53: 203-208, 1995. – reference: 11) 坂井陳作, 徳永有紀, 他：基礎疾患のない若年者に発生した口底部非クロストリジウム性ガス蜂窩織炎の1例. 日口外誌 46: 599-601, 2000. – reference: 2) 伊藤 聡, 森田悦弥, 他：歯性感染症から進展した頸部蜂巣炎, 縦隔炎の1例. 日口外誌 53: 489-492, 2005. – reference: 13) 平林秀樹：口腔咽頭喉頭疾患 深頸部膿瘍. 耳喉頭頸 81: 473-476, 2009. – reference: 4) 遠藤邦彦, 市川健司, 他：縦隔炎を併発した歯性感染症の1例. 日口外誌 36: 1060-1065, 1990. – reference: 3) Bonapart IE, Stevens HP, et al : Rare complications of an odontogenic abscess:mediastinitis, thoracic empyema and cardiac tamponade. J Oral Maxillofac Surg 53: 610-613, 1995. – reference: 6) Dellinger RP, Levy MM, et al : Surviving Sepsis Campaign :international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 36: 296-327, 2008. – reference: 10) 内山公男, 磯畑祐司, 他：腎透析患者に発生した重篤な歯性感染症の1例. 口科誌 42: 558-561, 1993. – reference: 15) Paul L Marino : The ICU Book（監訳者：稲田英一）, 第3版, 株式会社メディカル・サイエンス・インターナショナル, 東京都, 2009, 642-647頁. – reference: 14) 原 祐郁, 鈴木光隆：Descending necrotizing mediastinitis の臨床的検討. 日呼外会誌 22: 976-980, 2008. – reference: 1) 鹿嶋光司, 黒川英雄, 他：集中治療で救命し得た智歯周囲炎に起因する顔面頸部蜂窩織炎・縦隔炎・両側膿胸の1例. 日口外誌 53: 420-424, 2007. – reference: 7) 森脇義弘, 吉田謙一, 他：下行性壊死性縦隔炎に対する前方アプローチによる縦隔ドレナージ. 日消外会誌 35: 460-464, 2002. – reference: 8) 廣田哲也, 小泉雅英, 他：下縦隔にまで進展したdescending necrotizing mediastinitis の1救命例. 日 救急医会誌 9: 600-604, 1998. – reference: 9) 川真田修, 青山正博, 他：ドレナージにて救命したdescending necrotizing mediastinitis の2例. 日臨外会誌 59: 104-107, 1998. – reference: 12) Rallis G, Papadakis D, et al : Rare complications of a dental abscess. Gen Dent 54: 44-45, 2006. |
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| SubjectTerms | 下行性壊死性縦隔炎 抜歯後感染 深頸部膿瘍 |
| Title | 抜歯後に生じた下行性壊死性縦隔炎の1例 |
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