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Open Med (Wars). 2016 Nov 19;11(1):449-460. doi: 10.1515/med-2016-0080. eCollection 2016.

Descending necrotizing mediastinitis in the elderly patients.

Author information

1
Thoracic Surgery Unit, Second University of Naples, Italy.
2
Maxillo-Facial Surgery Unit, Second University of Naples, Italy.
3
Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy.
4
Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Naples, Italy.
5
Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Italy.
6
Department of Cardiothoracic and Respiratory Sciences, Second University of Naples/Hosp. Monaldi, Piazza Miraglia, 2, 80138 Naples, Italy.

Abstract

Descending Necrotizing Mediastinitis (DNM) is a polymicrobic, dangerous and often fatal process, arising from head or neck infections and spreading along the deep fascial cervical planes, descending into the mediastinum. It can rapidly progress to sepsis and can frequently lead to death. It has a high mortality rate, up to 40% in the different series, as described in the literature. Surgical and therapeutic management has been discussed for long time especially in an elderly patient population. The literature has been reviewed in order to evaluate different pathogenesis and evolution and to recognise a correct therapeutic management.

KEYWORDS:

Descending necrotizing mediastinitis; Head and neck infection; Management

Conflict of interest statement

Conflict of Interests: The authors declare that they have no conflict of interests.

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