- 期刊
Cervical Drainage of Descending Necrotizing Mediastinitis Caused by Deep Neck Infection
深頸部感染合併下行性壞死性縱隔腔炎
摘要
因深頸部感染造成的下行性壞死性縱隔腔炎並不常見，致死率約在40﹪。我們報告一例75歲女性病人，有肝硬化及糖尿病史，於上呼吸道感染後出現呼吸困難及發聲障礙。喉鏡檢查顯示，會厭腫脹及右側咽膿瘍併狹窄之呼吸道，經緊急氣管切開以維持呼吸道後，電腦斷層顯示頸部及上縱隔腔膿瘍。我們施以經頸部切開引流術，加以靜脈注射抗生素，並控制其血糖，病人得以康復出院。深頸部感染合併縱隔腔膿瘍致死率高，又見於此有糖尿病併肝硬化之女性病人，實不多見，特此提出報告。
並列摘要
Descending necrotizing mediastinitis (DNM) is a lethal process which originates from an oral or pharyngeal infection and descends along fascial planes into the mediastinum. Even with early antibiotic treatment and surgical drainage, the mortality rate remains high. We report a 75-year-old woman with diabetes and chronic liver cirrhosis who presented with symptoms of sore throat, muffled voice, and dyspnea. Parapharyngeal infection was initially identified; computed tomography revealed diffused deep neck infection with upper mediastinum involvement. Emergency tracheostomy and cervical incision and drainage were performed. The patient survived and was discharged after 51 days of systemic antibiotic treatment. DNM caused by deep neck infection is an uncommon but extremely aggressive form of mediastinitis. The importance of timely drainage and proper antibiotic treatment should be emphasized.
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