Author/Editor		Juretić, Mirna; Belušić-Gobić, Margita; Kukuljan, Melita; Cerović, Robert; Golubović, Vesna; Gobić, David
Title		Mediastinitis and bilateral pleural empyema caused by an adontogenic infection
Translated title		Mediastinitis in empiem plevre zaradi širjenja zobnega vnetja
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 41, št. 2
Publication year		2007
Volume		str. 57-62
Language		eng
Abstract		Background. Although odontogenic infections are relatively frequent in the general population, intrathoracic dissemination is a rare complication. Acute purulent mediastinitis, knozon as descending necrotizing rnediastinitis (DNM), causes high mortality rate, even up to 40°a, despite high efficacy of antibiotic therapy and surgical interhentions. In rpre cases, unilateral or bilateral pleural ernpyema develops as a complication of DNM. Case report. This case report presents the treatment of a young, previously Ivealthy patient with mediastinitis and bilateral pleural empyema caused by an odontogenic infection. After a neck and pharynx re-incision, and as CT confirmed propagatt'on of the abscess to the thorax, thorncotomy zvas performed followed by CT controlled thoracic drainage with continued antibiotic therapy. The patient was cured, although the recognition of these complications was relatively delayed. Conclusions. Early diagnosis of DNM can save the patient, so if this severe complication is suspected, thoracic CT should be performed.
Summary		Izhodišča. Zobna vnetja so pogosta, vendar se redko širijo v vrat in v podorčje prsnega koša. Akutni gnojni mediastinitis (spuščajoči se nekrozantni mediastinitis) je bolezen, ki ima kljub zdravljenju z antibiotiki in kirurškim posegom do 40% smrtni izhod. Izjemno redko se kot posledica mediastinitsa razvije plevralni empiem. Prikaz primera. Prikazan je primer mladega, predhodno zdravega bolnika z mediastinitisom in obojestranskim plevralnim empiemom, ki je nastal kot posledica širjenja zobnega vnetja. V začetku je bil zdravljen s kirurškima posegoma na vratu. Po CT preiskavi prsnega koša, ki je pokazala širjenje vnetja v prsni koš, je bila narejena torakotomija in drenaža obojestranskega empiema plevre z antibiotskim zdravljenjem. Bolnik je ozdravel, kljub zakasnelem spoznanju zapleta zobnega vnetja. Zaključki. Pri zgodnji diagnostiki spuščajočega se nekrotizantnega mediastinitisa, ki nastane zaradi zobnega vnetja, je CT preiskava prsnega koša pomembna diagnostična metoda saj omogoča ustrezno zdravljenje bolnika.
Descriptors		MEDIASTINITIS EMPYEMA, PLEURAL PERIAPICAL ABSCESS TOMOGRAPHY, X-RAY COMPUTED