Issue N# 4 - 2012
Diffuse cervical cellulitis and descending mediastinitis.
Authors : Chassery G, Strunski V, Biet A, Ferary M, Page C. (Beauvais Amiens)
Ref. : Rev Laryngol Otol Rhinol. 2012;133,4:189-195.
Article published in french
Downloadable PDF document french
Purpose of the study: The principal objective is to evaluate the circumstances of diagnosis and the treatment of cervical cellulitis and descending mediastinitis. Material and method: It is about a retrospective study concerning ten patients, hospitalized between January 2000 and July 2011 in the University Hospital of Amiens for cervical cellulitis and descending mediastinitis, included according to Estrera’s criterion. Results: The starting point was oropharyngeal (tonsillitis) in 70% of the cases. The three main germs were Streptococcus spp, Streptococcus milleri and Prevotella spp. The diffusion of the infection was done mainly by retropharyngeal way. 70% presented a mediastinitis associated to cellulitis. All the patients were operated by cervical approach, two profited from an associated thoracic way. Only four patients did not have any complication of their cellulitis. One patient died. Conclusion: The early diagnosis of this pathology proves to be of primary importance. The treatment must be “aggressive”. The drainage of mediastinitis proves to be sufficient by trans-cervical way in the event of the involvement of the higher part of the mediastinum (mediastinitis Endo type I) whereas a thoracotomy appears essential in the event of involvement beyond the carina (mediastinitis Endo type II).
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