ArticleAntibiotics (Basel, Switzerland)2022
Multidisciplinary Approach in the Treatment of Descending Necrotizing Mediastinitis: Twenty-Year Single-Center Experience.
Article in Antibiotics (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Anatomical risk factors for descending necrotizing mediastinitis in deep neck infections.Turk gogus kalp damar cerrahisi dergisi · 2026Article
- A bibliometric analysis of research trends in mediastinitis: a rare, high mortality, and complex infectious disease.Journal of thoracic disease · 2026Article
- Recognizing Descending Necrotizing Mediastinitis in Adults: A Narrative Review of Diagnostic Dilemmas and Barriers.Cureus · 2026Review
- Improved surgical outcomes and predictors of prolonged hospitalization in descending necrotizing mediastinitis: A 20-Year retrospective study.General thoracic and cardiovascular surgery · 2026Article
- Descending Necrotizing Mediastinitis, When Mediastinal Drainage By Thoracoscopy Is Not Sufficient: Case Report and Review of the Literature.Clinical medicine insights. Case reports · 2026Article
- Narrative review of descending necrotizing mediastinitis, focusing on the etiology, classification-guided surgical management, treatments, and prognosis.Mediastinum (Hong Kong, China) · 2026Review
- Antibiotic-Only Treatment of Pediatric Retropharyngeal and Parapharyngeal Abscess: A Case Report.Cureus · 2025Article
- Antimicrobial Resistance in Sub-Saharan Africa: A Comprehensive Landscape Review.The American journal of tropical medicine and hygiene · 2025Review
- 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
- Retrospective analysis of the positive effect of emergency room national early warning score 2 on descending necrotizing mediastinitis patients.BMC cardiovascular disorders · 2025Article
- Management and Outcomes of Descending Necrotizing Mediastinitis: A 15-Year Experience.Journal of clinical medicine · 2025Article
- Multidisciplinary Management of Descending Necrotizing Mediastinitis: Is Thoracoscopic Treatment Feasible?Journal of clinical medicine · 2024Article
- Descending necrotizing mediastinitis: key points to reduce the high associated mortality in a consecutive case series.Mediastinum (Hong Kong, China) · 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
- Video-assisted thoracic surgery drainage is feasible and safe for acute necrotizing mediastinitis: a retrospective cohort study.Journal of thoracic disease · 2023Article
- Article
- Surgical therapy and outcome of descending necrotizing mediastinitis in Chinese: a single-center series.Frontiers in medicine · 2023Article
- Traumatic chest wall pyomyositis presenting with mediastinitis.Journal of surgical case reports · 2022Article
- Risk Factors Associated with Post-Operative Complications in Multidisciplinary Treatment of Descending Necrotizing Mediastinitis.Journal of clinical medicine · 2022Article
- Antibiotics and Infectious Respiratory Diseases.Antibiotics (Basel, Switzerland) · 2022Article
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Authors and funding
20 authors.
Funding
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Abstract
Descending necrotizing mediastinitis (DNM) is an acute, rare, severe condition with high mortality, but the optimal management protocol is still controversial. We retrospectively analyzed the results of multidisciplinary management in patients treated for DNM at our center over the last twenty years. Fifteen male patients, mean age 49.07 ± 14.92 years, were treated: 9 with cervico-pharyngeal etiopathogenesis, 3 peri-tonsillar/tonsillar, 2 odontogenic, 1 post-surgical; 6 with DNM type I, 6 with type IIA, and 3 with type IIB (Endo's classification). Mean time between diagnosis and treatment was 2.24 ± 1.61 days. In all cases, mediastinum drainage via thoracotomy was performed after neck drainage via cervicotomy, associated with tooth treatment in two; one required re-operation; tracheostomy was necessary in 9, temporary intensive care unit stay in 4; 6 developed complications, without post-operative mortality. Main isolated germs were Staphylococci and Candida; 7 had polymicrobial infection. The most used antibiotics were meropenem, metronidazole, teicoplanin, third-generation cephalosporins and clyndamicin; anti-fungal drugs were fluconazole, caspofungin and anidulafungin. On multivariate analysis, presence of cardiovascular disease was statistically significantly associated with longer chest tube duration and hospital stay. DNM requires early diagnosis and treatment to reduce mortality and morbidity. The most effective treatment should provide a multidisciplinary approach, combining cervicotomy and thoracotomy to drain all infectious collections with administration and monitoring of the proper antimicrobial therapy.
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