Descending necrotizing mediastinitis is a severe, fulminant, life-threatening bacterial infection of the mediastinum. Even though improvements in diagnostics and treatment were achieved, the mortality rate remain shigh. Contrast-enhanced CT of chest and neck is the diagnostic gold standard. Radical debridement and drainage of the mediastinum should be considered the primary therapeutic target. The authors present a complicated case of a female patient with cervical necrotizing fasciitis and descending necrotizing mediastinitis. She was initially treated for a deep neck infection at the department of otorhinolaryngology. Surgical treatment, antibiotics, and intensive care became an integral part of the therapy after the transfer to the department of thoracic surgery. The authors had to face various complications with tracheostomy and extensively debrided soft tissues in the neck region. That is why the patient underwent repeated surgeries during several hospital stays, with an overall duration of treatment reaching 220 days.

• Klíčová slova
• deep neck infection, descending necrotizing mediastinitis, tracheostomy,
• MeSH
• drenáž MeSH
• fasciitida nekrotizující chirurgie   MeSH
• krk MeSH
• lidé MeSH
• mediastinitida komplikace   diagnostické zobrazování   chirurgie   MeSH
• nekróza MeSH
• tracheostomie MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The term of acute purulent mediastinitis (APM) is understood as a bacterial inflammatory process involving mediastinal tissue and organs. It is a group of clinical disorders originated primary or secondary as a complications another disease of different etiology. The definitive clinical picture is a combination of both pathologies. APM having obviously purulent character develops usually extremly fast and is objectively harming patient's life. In case of Descending Necrotizing Mediastinitis (DNM) the mortality is up to 25-40%. The only perfect and early stated diagnosis and choosen effective therapy mode can lead to patient life salvage and survival. The surgery share on therapy is substantional. During years 2004-2008 we have taken experience in this field by treatment of 18 patients with APM. Our conclusions after that most important condition for effective therapy is early and enough wide dissection of the involved area, mainly thoracocervical and mediastinal, their drainage and installation of the continual rinsing, eventually. There is no exception we indicate an operative repeated revision including rethoracotomy, if necessary.

• MeSH
• akutní nemoc MeSH
• bromhexin MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mediastinitida * diagnostické zobrazování   mikrobiologie   terapie   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• rentgendiagnostika MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• bromhexin MeSH

• Klíčová slova
• ANGIOGRAPHY *, LUNG/radiography *, MEDIASTINITIS/radiography *,
• MeSH
• angiografie * MeSH
• lidé MeSH
• mediastinitida diagnostické zobrazování   MeSH
• mediastinum * MeSH
• plíce diagnostické zobrazování   MeSH
• rentgendiagnostika hrudníku * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH