Update on necrotizing mediastinitis: Causes, approaches to management, and outcomes

Current Infectious Disease Reports

Volumn 13, Issue 3, 2011, Pages 278-286

  Sandner, Annett ^a   Börgermann, Jochen ^b  

^a MARTIN LUTHER UNIVERSITY HALLE WITTENBERG   (Germany)

^b RUHR UNIVERSITY BOCHUM   (Germany)

Author keywords

Cervicotomy; Clinical presentation; Descending necrotizing mediastinitis (DNM); Mediastinal drainage; Mortality; Outcomes; Surgical therapy; Thoracoscopic drainage; Thoracotomy; Video assisted thoracic surgery (VATS)

Indexed keywords

C REACTIVE PROTEIN; CEPHALOSPORIN; CLINDAMYCIN; IMMUNOGLOBULIN; INTERLEUKIN 6; METRONIDAZOLE; OXYGEN; PROCALCITONIN;

ARTICLE; BACTEROIDES; COMPUTER ASSISTED TOMOGRAPHY; DESCENDING NECROTIZING MEDIASTINITIS; DISEASE COURSE; EARLY DIAGNOSIS; EARLY INTERVENTION; ENDOSCOPIC SURGERY; HUMAN; HYPERBARIC OXYGEN; INTENSIVE CARE; LABORATORY TEST; LEUKOCYTOSIS; MEDIASTINITIS; MORTALITY; NECK INJURY; ORAL SURGERY; PATIENT CARE; STREPTOCOCCUS; SURGICAL DRAINAGE; THORACOTOMY; TOOTH INFECTION; TREATMENT OUTCOME; VIDEO ASSISTED MEDIASTINOSCOPIC SURGERY; VIDEO ASSISTED THORACOSCOPIC SURGERY;

EID: 79956208117     PISSN: 15233847     EISSN: 15343146     Source Type: Journal    
DOI: 10.1007/s11908-011-0174-z     Document Type: Article

References (52)

1. AS Estrera MJ Landay JM Grisham, et al. 1983 Descending necrotizing mediastinitis Surg Gynecol Obstet. 157 545 552 6648776 1:STN:280: DyaL2c%2FntlKmtw%3D%3D (Pubitemid 14201134)
2. HE Pearse 1938 Mediastinitis following cervical suppuration Ann Surg. 108 588 611 17857255 10.1097/00000658-193810000-00009 1:STN:280: DC%2BD2srkt1ehtw%3D%3D
3. GJ Ridder W Maier S Kinzer, et al. 2010 Descending necrotizing mediastinitis: contemporary trends in etiology, diagnosis, management, and outcome Ann Surg. 251 528 534 19858699 10.1097/SLA.0b013e3181c1b0d1 This article provides a helpful review of DNM. It is the most recent retrospective study and the largest single-center study since 1960; it is also the most recent meta-analysis
4. A Karkas K Chahine S Schmerber, et al. 2010 Optimal treatment of cervical necrotizing fasciitis associated with descending necrotizing mediastinitis Br J Surg. 97 609 615 20169565 10.1002/bjs.6935 1:STN:280:DC%2BC3c7mvFKrsA%3D%3D This report generates a management algorithm for DNM. It provides guidance for diagnosis and therapy, and compares mortality rates from 1995 to the present
5. S Jarboui H Jerraya A Moussi, et al. 2009 Descending necrotizing mediastinitis of odontogenic origin Tunis Med. 87 770 775 20209836
6. KC Chen JS Chen SW Kuo, et al. 2008 Descending necrotizing mediastinitis: a 10-year surgical experience in a single institution J Thorac Cardiovasc Surg. 136 191 198 18603075 10.1016/j.jtcvs.2008.01.009 This study discusses several approaches to management of DNM, including minimally invasive procedures (eg, VATS)
7. M Deu-Martín M Saez-Barba I López Sanz, et al. 2010 Mortality risk factors in descending necrotizing mediastinitis Arch Bronconeumol. 46 182 187 20227809
8. B Lanisnik B Cizmarevic 2010 Necrotizing fasciitis of the head and neck: 34 cases of a single institution experience Eur Arch Otorhinolaryngol. 267 415 421 19551399 10.1007/s00405-009-1007-7
9. Y Sumi H Ogura Y Nakamori, et al. 2008 Nonoperative catheter management for cervical necrotizing fasciitis with and without descending necrotizing mediastinitis Arch Otolaryngol Head Neck Surg. 134 750 756 18645126 10.1001/archotol.134.7.750
10. F Roccia GC Pecorari A Oliaro, et al. 2007 Ten years of descending necrotizing mediastinitis: management of 23 cases J Oral Maxillofac Surg. 65 1716 1724 17719388 10.1016/j.joms.2006.10.060 (Pubitemid 47268603)
11. Y Inoue M Gika K Nozawa, et al. 2005 Optimum drainage method in descending necrotizing mediastinitis Interact Cardiovasc Thorac Surg. 4 189 192 17670389 10.1510/icvts.2004.105395 (Pubitemid 41289176)
12. P Misthos S Katsaragakis S Kakaris, et al. 2007 Descending necrotizing anterior mediastinitis: analysis of survival and surgical treatment modalities J Oral Maxillofac Surg. 65 635 639 17368356 10.1016/j.joms.2006.06.287 This article shows that early combined transthoracic mediastinal and cervical debridement is the only favorable factor for survival in patients with DNM (Pubitemid 46412598)
13. Y Nakamori S Fujimi H Ogura, et al. 2004 Conventional open surgery versus percutaneous catheter drainage in the treatment of cervical necrotizing fasciitis and descending necrotizing mediastinitis Am J Roentgenol. 182 1443 1449 (Pubitemid 38668844)
14. J Gawrychowski W Rokicki M Rokicki 2003 Descending necrotic mediastinitis-course and methods of surgical treatment Pneumonol Alergol Pol. 71 17 23 12959019 (Pubitemid 36596835)
15. E Papalia O Rena A Oliaro, et al. 2001 Descending necrotizing mediastinitis: surgical management Eur J Cardiothorac Surg. 20 739 742 11574217 10.1016/S1010-7940(01)00790-4 1:STN:280:DC%2BD3MrivVWntA%3D%3D (Pubitemid 33713618)
16. A Pérez G Cueto G de la Escosura R Cicero 2003 Descending necrotizing mediastinitis. Results of medical-surgical treatment in 17 cases Gac Med Mex. 139 199 204 12872411
17. CH Marty-Ané JP Berthet P Alric, et al. 1999 Management of descending necrotizing mediastinitis: an aggressive treatment for an aggressive disease Ann Thorac Surg. 68 212 217 10421143 10.1016/S0003-4975(99)00453-1 (Pubitemid 29338992)
18. M Makeieff N Gresillon JP Berthet, et al. 2004 Management of descending necrotizing mediastinitis Laryngoscope. 114 4 772 775 15064640 10.1097/00005537-200404000-00035 (Pubitemid 38548796)
19. RK Freeman E Vallières ED Verrier, et al. 2000 Descending necrotizing mediastinitis: an analysis of the effects of serial surgical debridement on patients mortality J Thoracic Cardiovasc Surg. 119 260 267 10.1016/S0022-5223(00)70181-4 1:STN:280:DC%2BD3c7hsFOntA%3D%3D (Pubitemid 30091799)
20. R Figueroa-Damián 2001 Clinical manifestations and lethality of descending necrotizing mediastinitis Rev Invest Clin. 53 35 40 11332049 (Pubitemid 33681655)
21. T Iwata Y Sekine K Shibuya, et al. 2005 Early open thoracotomy and mediastinopleural irrigation for severe descending necrotizing mediastinitis Eur J Cardiothorac Surg. 28 384 388 16046266 10.1016/j.ejcts.2005.05.018 (Pubitemid 41169188)
22. K Shimizu Y Otani T Nakano, et al. 2006 Successful video-assisted mediastinoscopic drainage of descending necrotizing mediastinitis Ann Thorac Surg. 81 2279 2281 16731169 10.1016/j.athoracsur.2005.07.096 (Pubitemid 43775522)
23. T Nagayasu S Akamine T Oka M Muraoka 2003 Thoracoscopic drainage with wound edge protector for descending necrotizing mediastinitis Interact Cardiovasc Thorac Surg. 2 58 60 17669988 10.1016/S1569-9293(02)00090-7 (Pubitemid 37443561)
24. N Isowa T Yamada T Kijima, et al. 2004 Successful thoracoscopic debridement of descending necrotizing mediastinitis Ann Thorac Surg. 77 1834 1837 15111204 10.1016/S0003-4975(03)01260-8 (Pubitemid 38530043)
25. F Stella F Petrella 2005 Transsternal transpericardial approach for acute descending necrotizing mediastinitis J Thorac Cardiovasc Surg. 129 212 214 15632847 10.1016/j.jtcvs.2004.04.020 (Pubitemid 40038118)
26. S Hirai Y Hamanaka N Mitsui, et al. 2004 Surgical treatment of virulent descending necrotizing mediastinitis Ann Thorac Cardiovasc Surg. 10 34 38 15008697
27. M Sonobe M Miyazaki M Nakagawa, et al. 1999 Descending necrotizing mediastinitis with sternocostoclavicular osteomyelitis and partial thoracic empyema: report of a case Surg Today. 29 1287 1289 10639715 10.1007/BF02482226 1:STN:280:DC%2BD3c7gtlyqtA%3D%3D (Pubitemid 30026626)
28. I Tateya N Fujiki K Kurata, et al. 2003 Descending necrotizing mediastinitis following acute epiglottitis: a case report Eur Arch Otorhinolaryngol. 260 128 130 12687383 (Pubitemid 36437748)
29. A Iyoda T Yusa T Fujisawa, et al. 1999 Descending necrotizing mediastinitis: report of a case Surg Today. 29 1209 1212 10552344 10.1007/BF02482275 1:STN:280:DC%2BD3c%2FhvFykuw%3D%3D
30. V Malik C Gadepalli S Agrawal, et al. 2010 An algorithm for early diagnosis of cervicofacial necrotising fasciitis Eur Arch Otorhinolaryngol. 267 1169 1177 20396897 10.1007/s00405-010-1248-5
31. EG Eter A Khazzaka W Mneimneh, et al. 2009 Does diclofenac increase the risk of cervical necrotizing fasciitis in a rat model? Int J Exp Pathol. 90 58 65 19200252 10.1111/j.1365-2613.2008.00594.x 1:CAS:528:DC%2BD1MXjtlWgtb0%3D
32. H Wolf T Ovesen 2008 Necrotizing fasciitis in the head and neck region Ugeskr Laeger. 170 2563 2566 18761840
33. A Sandner J Börgermann S Kösling, et al. 2007 Descending necrotizing mediastinitis: early detection and radical surgery are crucial J Oral Maxillofac Surg. 65 794 800 17368383 10.1016/j.joms.2005.11.075 (Pubitemid 46420618)
34. P Mihos K Potaris I Gakidis, et al. 2004 Management of descending necrotizing mediastinitis J Oral Maxillofac Surg. 62 966 972 15278861 10.1016/j.joms.2003.08.039 (Pubitemid 38962615)
35. A Brunelli A Sabbatini G Catalani A Fianchini 1996 Descending necrotizing mediastinitis. Surgical drainage and tracheostomy Arch Otolaryngol Head Neck Surg. 122 1326 1329 8956744 1:STN:280:DyaK2s7hsFensQ%3D%3D (Pubitemid 26408914)
36. DN Exarhos K Malagari EG Tsatalou, et al. 2005 Acute mediastinitis: spectrum of computed tomography findings Eur Radiol. 15 1569 1574 15627194 10.1007/s00330-004-2538-3 1:STN:280:DC%2BD2Mzns1ensA%3D%3D (Pubitemid 41102350)
37. LM Sancho H Minamoto A Fernandez, et al. 1999 Descending necrotizing mediastinitis: a retrospective surgical experience Eur J Cardiothorac Surg. 16 200 205 10485421 10.1016/S1010-7940(99)00168-2 1:STN:280:DyaK1MvhtlCgsw%3D%3D (Pubitemid 29376676)
38. S Endo F Murayama T Hasegawa, et al. 1999 Guideline of surgical management based on diffusion of descending necrotizing mediastinitis Jpn J Thorac Cardiovasc Surg. 47 14 19 10077888 10.1055/s-2007-1013101 1:STN:280:DyaK1M7nslKitg%3D%3D
39. JT Kim KH Kim SW Lee K Sun 1999 Descending necrotizing mediastinitis: mediastinal drainage with or without thoracotomy Thorac Cardiovasc Surg. 47 333 335 10599963 10.1055/s-2007-1013168 1:STN:280:DC%2BD3c%2Fms12ntA%3D%3D
40. M Gorlitzer M Grabenwoeger J Meinhart, et al. 2007 Descending necrotizing mediastinitis treated with rapid sternotomy followed by vacuum-assisted therapy Ann Thorac Surg. 83 393 396 17257957 10.1016/j.athoracsur.2006.09.059 (Pubitemid 46135462)
41. Y Moriwaki M Sugiyama G Matsuda, et al. 2002 Approach for drainage of descending necrotizing mediastinitis on the basis of the extending progression from deep neck infection to mediastinitis J Trauma. 53 112 116 12131401 10.1097/00005373-200207000-00023 (Pubitemid 34863964)
42. I Takanami M Naruke S Kodaira 1998 The surgical approach for descending necrotizing mediastinitis: report of two cases Surg Today. 28 1200 1202 9851634 10.1007/s005950050314 1:STN:280:DyaK1M%2Fms12muw%3D%3D (Pubitemid 28547586)
43. M Lanuti 2007 Invited commentary Ann Thorac Surg. 83 396 17257958 10.1016/j.athoracsur.2006.10.042 (Pubitemid 46135477)
44. RP De Freitas CP Fahy DS Brooker, et al. 2007 Descending necrotizing mediastinitis: a safe treatment algorithm Eur Arch Otorhinolaryngol. 264 181 187 17009018 10.1007/s00405-006-0174-z (Pubitemid 46011301)
45. S Watanabe K Kariatsumari K Sakasegawa, et al. 2002 A new combined surgical procedure for severe descending necrotizing mediastinitis with bilateral empyema Thorac Cardiovasc Surg. 50 308 310 12375190 10.1055/s-2002-34577 1:STN:280:DC%2BD38nhsl2hsg%3D%3D (Pubitemid 35252760)
46. HK Min YS Choi YM Shim, et al. 2004 Descending necrotizing mediastinitis: a minimally invasive approach using video-assisted thoracoscopic surgery Ann Thorac Surg. 77 306 310 14726084 10.1016/S0003-4975(03)01333-X (Pubitemid 38130033)
47. JS Cho IH Kim YD, et al. 2008 Treatment of mediastinitis using video-assisted thoracoscopic surgery Eur J Cardiothorac Surg. 34 520 524 18579395 10.1016/j.ejcts.2008.05.034 This study describes VATS as a feasible surgical option in the treatment of mediastinitis
48. T Murakawa Y Yoshida T Fukami J Nakajima 2010 Life-threatening tracheal perforation secondary to descending necrotizing mediastinitis Interact Cardiovasc Thorac Surg. 10 454 456 19955171 10.1510/icvts.2009.225912 These authors present a very complex case of DNM with tracheal perforation, which was successfully treated
49. H Ichimura S Ishikawa Y Hiramatsu, et al. 2001 Innominate artery rupture after transcervical drainage for descending necrotizing mediastinitis Ann Thorac Surg. 71 1028 1030 11269423 10.1016/S0003-4975(00)02439-5 1:STN:280: DC%2BD3M7mvVSrsA%3D%3D (Pubitemid 32210434)
50. JR Roberts WR Smythe RW Weber, et al. 1997 Thoracoscopic management of descending necrotizing mediastinitis Chest. 112 850 854 9315828 10.1378/chest.112.3.850 1:STN:280:DyaK2svlvFylug%3D%3D (Pubitemid 27410731)
51. MJ Wheatley MC Stirling MM Kirsh, et al. 1990 Descending necrotizing mediastinitis: transcervical drainage is not enough Ann Thorac Surg. 49 780 784 2288561 10.1016/0003-4975(90)90022-X 1:STN:280:DyaK3c3ltlaksg%3D%3D (Pubitemid 20172618)
52. PD Kiernan A Hernandez WD Byrne, et al. 1998 Descending cervical mediastinitis Ann Thorac Surg. 65 1483 1488 9594903 10.1016/S0003-4975(98)00142- 8 1:STN:280:DyaK1c3lslamuw%3D%3D (Pubitemid 28241732)