Descending necrotizing mediastinitis (DNM) is a life-threatening disease which often develops from a purulent infection of the oral cavity and is associated with high rates of mortality. Here we report the case of a young patient who died from an aortic arch rupture in context of DNM developed from an odontogenic infection caused by Prevotella buccae. Based on the current knowledge on this very rare vascular complication, we discuss factors that may have contributed to this fatal issue and future issues to optimize care provided to patients.
Prado-CallerosHMJimenez-FuentesEJimenez-EscobarI. Descending necrotizing mediastinitis: Systematic review on its treatment in the last 6 years, 75 years after its description. Head Neck. 2016; 38(suppl 1): E2275–E2283.
Marty-AneCHBerthetJPAlricPPegisJDRouvierePMaryH. Management of descending necrotizing mediastinitis: An aggressive treatment for an aggressive disease. Ann Thorac Surg. 1999; 68(1): 212–217.
4.
MisthosPKatsaragakisSKakarisSTheodorouDSkottisI. Descending necrotizing anterior mediastinitis: Analysis of survival and surgical treatment modalities. J Oral Maxillofac Surg. 2007; 65(4): 635–639.
5.
KarkasAChahineKSchmerberSBrichonPYRighiniCA. Optimal treatment of cervical necrotizing fasciitis associated with descending necrotizing mediastinitis. Br J Surg. 2010; 97(4): 609–615.
6.
SarnaTSenguptaTMiloroMKolokythasA. Cervical necrotizing fasciitis with descending mediastinitis: Literature review and case report. J Oral Maxillofac Surg. 2012; 70(6): 1342–1350.
7.
PalmaDMGiulianoSCracchioloAN. Clinical features and outcome of patients with descending necrotizing mediastinitis: Prospective analysis of 34 cases. Infection. 2016; 44(1): 77–84.
8.
SinghAKhajaAAlpertMA. Cocaine and aortic dissection. Vasc Med. 2010; 15(2): 127–133.
9.
EagleKAIsselbacherEMDeSanctisRW; International Registry for Aortic Dissection I. Cocaine-related aortic dissection in perspective. Circulation. 2002; 105(13): 1529–1530.
10.
HudorovicNVuceticB. Infrequent life-threatening complication of descending necrotizing mediastinitis; vertebral artery, internal jugular and subclavian vein rupture. Int J Surg. 2008; 6(6): e48–e51.
11.
IchimuraHIshikawaSHiramatsuYSakakibaraYOnizukaM. Innominate artery rupture after transcervical drainage for descending necrotizing mediastinitis. Ann Thorac Surg. 2001; 71(3): 1028–1030.
12.
ChevalierATKhajaMSYangB. Surgical management of necrotizing mediastinitis with large aortic pseudoaneurysm. Ann Thorac Surg. 2016; 101(5): e143–e145.
13.
MaroneEMCoppiGKahlbergATshombaYChiesaR. Combined endovascular and surgical treatment of primary aortoesophageal fistula. Tex Heart Inst J. 2010; 37(6): 722–724.
14.
TopelIStehrASteinbauerMGPisoPSchlittHJKasprzakPM. Surgical strategy in aortoesophageal fistulae: Endovascular stentgrafts and in situ repair of the aorta with cryopreserved homografts. Ann Surg. 2007; 246(5): 853–859.
15.
AlauzetCMarchandinHLozniewskiA. New insights into Prevotella diversity and medical microbiology. Future Microbiol. 2010; 5(11): 1695–1718.
