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Descending necrotizing mediastinitis: report of a case following steroid neck injection

Published online by Cambridge University Press:  08 March 2006

R. P. S. Harar ,
C. Cranston  and
N. Warwick-Brown
R. P. S. Harar
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Southend Hospital, Westcliff on Sea, UK.
C. Cranston
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Southend Hospital, Westcliff on Sea, UK.
N. Warwick-Brown
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Southend Hospital, Westcliff on Sea, UK.
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Abstract

Cervical necrotizing fasciitis is a rare, rapidly progressive, severe bacterial infection of the soft tissues of the neck. Uncommonly, it may descend into the mediastinum. We describe a case of descending necrotizing mediastinitis in a young man, where there was diagnostic confusion and delay, with an eventual fatal outcome. A steroid injection for neck pain is thought to be the source of infection. In this case, the signs of mediastinitis were initially masked, and the diagnosis delayed until cardiopulmonary arrest occurred. Early recognition with a low threshold for computed tomography (CT) scanning is essential. Aggressive multidisciplinary therapy with mediastinal drainage is mandatory.

Keywords

NecrosisNeckMediastinitisSteroids
Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 116 , Issue 10 , October 2002 , pp. 862 - 864
Copyright
© Royal Society of Medicine Press Limited 2002

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