Document Detail

Mediastinitis in infants from deep neck space infections.
MedLine Citation:
PMID:  19467419     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe mediastinitis in infants. STUDY DESIGN: Case series. SETTING: Tertiary-care, academic, pediatric hospital. SUBJECTS: Four infants managed during eight months. RESULTS: Patients were eight months (two patients), nine months, and 18 months old. They had retropharyngeal phlegmons and were started on clindamycin/cephalosporin. Interval imaging scans revealed abscess formation with mediastinal extension. All retropharyngeal abscesses were drained; three patients required video-assisted thoracoscopic debridement. Methicillin-resistant Staphylococcus aureus (two patients) and methicillin-sensitive Staphylococcus aureus (two patients) were cultured. Peak white blood cell counts were 15,000, 18,400, 30,200, and 44,900. The patients survived without long-term morbidity. CONCLUSIONS: In infants with pediatric deep neck space infections, increased vigilance should be maintained for progression to mediastinal extension. Optimal management includes imaging of the neck and chest as indicated, broad-spectrum antibiotic coverage, and aggressive surgery as warranted to clear the neck space infections with appropriate surgical consultants to manage the mediastinal process. Despite high morbidity and mortality in adult mediastinitis, infant mediastinitis may be a different disease process as all patients survived without sequelae.
Rahul K Shah; Robert Chun; Sukgi S Choi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  140     ISSN:  0194-5998     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-26     Completed Date:  2009-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  936-8     Citation Subset:  IM    
Division of Otolaryngology, Children's National Medical Center, The George Washington University Medical Center, Washington, DC 20010, USA.
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MeSH Terms
Abscess / complications*,  radiography,  therapy
Anti-Bacterial Agents / therapeutic use
Mediastinitis / microbiology*,  radiography,  therapy
Neck* / radiography
Staphylococcal Infections / complications*,  radiography,  therapy
Staphylococcus aureus
Tomography, X-Ray Computed
Reg. No./Substance:
0/Anti-Bacterial Agents

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