ArticleInfection2016
Clinical features and outcome of patients with descending necrotizing mediastinitis: prospective analysis of 34 cases.
Article in Infection, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
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Who cites it
37 citing papers in PubMed, 76 citations in OpenAlex.
- Endoscopic transcervical mediastinal drainage for treating descending necrotizing mediastinitis.BMC surgery · 2026Observational
- Narrative review of descending necrotizing mediastinitis, focusing on the etiology, classification-guided surgical management, treatments, and prognosis.Mediastinum (Hong Kong, China) · 2026Review
- Surgical management of complex mediastinitis: an 8-year single-centre experience reinforcing the role of open thoracotomy.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Descending necrotizing mediastinitis complicating deep neck abscesses: clinical features and prognostic assessment in 45 ICU patients.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Observational
- Management and Outcomes of Descending Necrotizing Mediastinitis: A 15-Year Experience.Journal of clinical medicine · 2025Article
- Descending Necrotizing Mediastinitis: A Rare Yet Lethal Complication Demanding Timely Intervention.Cureus · 2024Article
- Article
- Infectious Mediastinitis: A Retrospective Cohort Study.Open forum infectious diseases · 2024Article
- Descending necrotising mediastinitis: a rare entity in children.BMJ case reports · 2024Article
- Descending necrotizing mediastinitis with esophageal perforation and tracheal ulcer: a case report and literature review.General thoracic and cardiovascular surgery cases · 2024Article
- Lung and mediastinum abscesses in Poland: a national hospital register-based study.Archives of medical science : AMS · 2024Article
- Demographic, clinical, and paraclinical features of patients operated with the diagnosis of acute descending necrotizing mediastinitis: a retrospective study in Southern Iran.Journal of cardiothoracic surgery · 2023Article
- A Machine Learning Approach to Assess Patients with Deep Neck Infection Progression to Descending Mediastinitis: Preliminary Results.Diagnostics (Basel, Switzerland) · 2023Article
- Article
- The efficacy of thoracoscopic surgery for descending necrotizing mediastinitis.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Descending necrotizing mediastinitis: etiopathogenesis, diagnosis, treatment and long-term consequences-a retrospective follow-up study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2023Article
- Evolution of the treatment of severe odontogenic infections over 50 years: A comprehensive review.Journal of Taibah University Medical Sciences · 2023Review
- [Lesions of the paravertebral mediastinum].Radiologie (Heidelberg, Germany) · 2023Review
- Surgical Experience with Descending Necrotizing Mediastinitis: A Retrospective Analysis at a Single Center.Journal of chest surgery · 2023Article
- Management of descending necrotizing mediastinitis with severe thoracic empyema using minimally invasive video-assisted thoracoscopic surgery: a case report.Translational pediatrics · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe aimed to investigate clinical features of patients with descending necrotizing mediastinitis (DNM) in order to improve management and outcome.
methodsWe prospectively examined all patients with DNM admitted to the Intensive Care Unit (ICU) during the period from April 2007 to December 2013. Demographics, clinical features, microbiology, medical and surgical treatment data were recorded. Survivor and nonsurvivor groups were analyzed to identify factors associated with mortality.
resultsOverall, 34 patients with DNM have been included. The mean age was 46.8 ± 11.2 years (range 24-70). The male/female ratio was 3.25. DNM arose from odontogenic infection in 22 (65%) patients; from peritonsillar abscess in 9 (26%) patients and from paranasal sinus in 3 (9%) patients. Microbiological cultures revealed a high percentage of aerobic/anaerobic coinfection. Nonsurvivors were statistically more likely to have higher SAPS II score (mean difference 19.1, 95% CI 12.3-25.9 P < 0.01) and more severe disease (P < 0.01) than survivors. Positive correlation was found between time to ICU admission after head or neck infection diagnosis and SAPS II score (ρ = 0.5, P = 0.03). The same was true for ICU length of stay and time to ICU admission (ρ = 0.6, P < 0.01) and time to surgery (ρ = 0.5, P = 0.03). Surgical treatments consisted in: transcervical drainage in 14 cases, (42%); irrigation through subxiphoid and cervical incisions of the anterior mediastinum with additional percutaneous thoracic drainage when necessary in ten cases, (29 %); thoracotomy with radical mediastinal surgical debridement, excision of necrotic tissue and decortication in ten cases, (29%). We have found a mortality rate of 12%. Patients with DNM type IIB were admitted to the ICU later than patients with DNM type I and type IIA (mean difference 3.2 days, 95% CI 1.2-5.1, P 0.02).
conclusionsPrompt ICU admission in order to manage severe sepsis and/or septic shock, along with early and aggressive surgery and adequate antimicrobial therapy, could be key factors in reducing DNM mortality.
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