Mediastinitis and bilateral pleural empyema caused by an odontogenic infection

  • Mirna Juretic
  • Margita Belusic-Gobic
  • Melita Kukuljan
  • Robert Cerovic
  • Vesna Golubovic
  • David Gobic

Abstract

Background. Although odontogenic infections are relatively frequent in the general population, intrathoracic dissemination is a rare complication. Acute purulent mediastinitis, known as descending necrotizing mediastinitis (DNM), causes high mortality rate, even up to 40%, despite high efficacy of antibiotic therapy and surgical interventions. In rare cases, unilateral or bilateral pleural empyema develops as a complication of DNM.

Case report. This case report presents the treatment of a young, previously healthy patient with mediastinitis and bilateral pleural empyema caused by an odontogenic infection. After a neck and pharynx re-incision, and as CT confirmed propagation of the abscess to the thorax, thoracotomy was performed followed by CT-controlled thoracic drainage with continued antibiotic therapy. The patient was cured, although the recognition of these complications was relatively delayed.

Conclusions. Early diagnosis of DNM can save the patient, so if this severe complication is suspected, thoracic CT should be performed.

Author Biographies

Mirna Juretic
Margita Belusic-Gobic
Melita Kukuljan
Robert Cerovic
Vesna Golubovic
David Gobic
Published
2007-06-01
How to Cite
Juretic, M., Belusic-Gobic, M., Kukuljan, M., Cerovic, R., Golubovic, V., & Gobic, D. (2007). Mediastinitis and bilateral pleural empyema caused by an odontogenic infection. Radiology and Oncology, 41(2). Retrieved from https://radioloncol.com/index.php/ro/article/view/1230
Section
Radiology