Mediastinitis in infants from deep neck space infections
Mediastinitis in infants from deep neck space infections
复制标题
颈部深部间隙感染引起的婴儿纵隔炎
DOI：
10.1016/j.otohns.2009.02.032
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Sukgi S. Choi
中科院分区：
文献类型：
--
作者：
R. Shah;Robert Chun;Sukgi S. Choi
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-resistantStaphylococcus aureus(two patients) and methicillin-sensitiveStaphylococcus 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.
