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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Perforations of the esophagus are uncommon complications of flexible gastrointestinal endoscopy. Perforations after endoscopy are likely to occur in the cervical esophagus, where fiber insertion is difficult anatomically. The diagnosis should be made as soon as possible, because mediastinitis and sepsis frequently develop following esophageal perforations. The surgical strategies are dependent on the location of the perforations and the condition of the patients. For a successful outcome, surgery is a preferred treatment for most perforation cases, and non-operative treatment, such as antibiotics, parental nutrition, and no food intake by mouth, should be applied carefully.
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PMID:Successfully treated case of cervical abscess and mediastinitis due to esophageal perforation after gastrointestinal endoscopy. 1244

We herein report about a case of perforation of the cervical esophagus by an artificial denture, which had been swallowed by the patient after a horse-related-injury. Impactation of the foreign body at the level of the upper esophageal sphincter was followed by its penetration through the esophageal wall, causing severe infection of the cervical soft tissue, mediastinitis and sepsis. We discuss the well-known phenomena of prosthesis ingestion and frequently delayed diagnosis, as well as our treatment strategy of cervical esophageal perforation with placement of a T-tube into the cervical esophagus and mediastinal drainage.
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PMID:Cervical esophageal perforation with severe mediastinitis due to an impacted dental prosthesis. 1247 85

Deep neck infection may be lethal, especially when life-threatening complications occur. We conducted a retrospective analysis of 184 patients with deep neck infection who were treated at Kaohsiung Medical University Hospital during the past 6 years. Factors such as age, sex, hospitalization days, clinical presentations, involved spaces, imaging studies, microbiology, and treatment method were analyzed. There were 122 men and 62 women with a mean age of 41.7 years. The average hospitalization was 8.4 days. The involved spaces, determined by physical examination and radiologic findings, were the peritonsillar space (59 patients), parapharyngeal space (77 patients), submandibular space (55 patients), and retropharyngeal space (20 patients). Of the 49 patients for whom the origin of infection was identified, 29 were infected via the upper respiratory tract and 13 had infection of odontogenic origin. The most common isolated organism was Klebsiella pneumoniae. One hundred and thirty-seven patients (74.5%) underwent surgery, including repeated needle aspiration (87 patients) and surgical drainage (50 patients). The remaining 47 patients recovered uneventfully with antibiotic therapy alone. Eighteen patients developed life-threatening complications, such as descending mediastinitis, sepsis, airway obstruction, and jugular vein thrombosis. Two patients died of septic shock. The combination of accurate diagnosis, effective antibiotic therapy, airway maintenance, and intensive surgical debridement for those who fail to respond to conservative treatment will lead to a good prognosis.
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PMID:Space infection of the head and neck. 1247 81

Descending necrotizing mediastinitis (DNM) is an infrequent clinical entity. DNM is the result of infection originating in the oropharyngeal regions and spreading along cervical fascial planes to cause mediastinal abscess and sepsis. Even with prompt recognition and treatment, the mortality and morbidity associated with DNM are appreciable. The opportunities for successful outcome are improved with liberal use of computed tomography, aggressive surgical therapy, and a multidisciplinary team approach. We report a case of DNM that illustrates how these principles were employed in the successful management of this rare and often fatal condition.
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PMID:Descending necrotizing mediastinitis. 1251 25

Descending necrotizing mediastinitis is a severe disease which occurs after a mild otorhinolaryngologic or dental infection. The diagnosis must be established rapidly with the help of clinical and computed tomography of the neck and chest data. Treatment is based on antibiotics, surgery and hyperbaric oxygen. The outcome is poor with high mortality. We report a case of septicemia complicating descending necrotizing mediastinitis after dental infection.
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PMID:[Descending necrotizing mediastinitis: a diagnosis not to miss]. 1254 35

The frequency of infective mediastinitis after open heart surgery, according data of various authors, ranges from 0.1% to 1%. In order to decrease amount of this type of complications the specialised department with 12 beds was established at the Heart Surgery Clinic of Vilnius University in January 1, 1991. Since that time till January 1, 2002, 330 patients were operated because infective mediastinitis after open heart operations. Original method of treatment of infective mediastinitis was elaborated. Mean stay of the patients treated by means of this method ranged from 14 to 34 days (mean - 24 day). Twenty four (7.4%) patients died because of progressing sepsis (8 patients - 33.3%), heart failure (10 patients - 41.6%), multiorgan failure - 4 (16.6%), other causes - 2 (8.3%). Although there is no common method of treatment of infective mediastinitis after open heart operations, we consider our method of treatment to be effective.
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PMID:[Eleven year experience of treatment mediastinitis after open heart surgery]. 1256 Jun 70

Between December 1972 and January 2002, 201 patients had replacement of the ascending aorta at Vilnius University Heart Surgery Clinic. 171 of them had aortic valve replacement, too, and 30 patients - without aortic valve correction. Septical complications post operation had 24 (11.94%) patients. Their age ranged from 30 to 73 years (mean 49.4 years). Most of the patients were male (87.5%) and IV functional class NYHA (70.8%) preoperatively. Main etiological factor of ascending aorta aneurysm was atherosclerosis, rare - Marfan's syndrome. Sepsis, prosthetic infective endocarditis was detected in 10 (41.7%), mediastinitis - in 9 (37.5%) and sepsis with mediastinitis - in 5 (20.8%) cases. Hospital period (< 1 month) septical complications were diagnosed in 91.7% of all cases. Total sepsis related hospital period mortality was 3.5%, late - 4.0% from all 201 operated. Septical complications were not common in patients after ascending aorta replacement. Reoperations were associated with early mortality and satisfactory long-term results. Conservative treatment was not successful.
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PMID:[Septical complications after ascending aorta replacement]. 1256 Jun 72

This paper presents the priority original methods (patent No. 2101046, Russia) for the treatment of inflammatory pyodestructive processes in the oral cavity, maxillofacial area, and neck (odontogenic abscesses and phlegmons including those complicated by mediastinitis and sepsis), sinusitis, carbuncles and furuncles of face and neck skin, parotitis, sialadenitis, adenophlegmons, lymphadenitis, periotitis, alveolitis, arthritis, arthrosis of the temporomandibular joint, odontogenic and traumatic osteomyelitis, infected purulent traumas (including gunshot ones), fractures of the jaws, etc. making use of Optodan laser (patent No. 2014107, Russia) for laser and magnetic-laser therapy.
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PMID:[Treatment of inflammatory pyodestructive processes of the oral cavity, maxillofacial area, and neck by laser and magnetic-laser exposure of the carotid sinus using the Optodan laser apparatus]. 1284 Nov 39

We treated a 62-year-old woman with a cervical necrotizing soft tissue infection of the Streptococcus milleri group. Numerous spot gas images were recognized from the right pharynx to the neck in CT at initial diagnosis, but we chose conservative treatment because abscess findings were not clear. The inflammation improved temporarily, but we operated through an outside incision because symptoms recurred and cervical skin became necrotic after one week. Inside, the fascia were necrotic and an abscess extended from the precordia to the left upper arm and the right axillary region. The cervical skin defect was restored in due course in about 2 months and cured without mediastinitis or sepsis developing. The S. milleri group was detected in pus. A cervical necrotizing soft tissue infection does not form an abscess mainly in one space as does a normal deep neck infection and invades fascia space rapidly and widely. We took this disease into consideration and had to intervene surgical rather soon. A review of this case and the literature indicates that the S. milleri group may have become an important pathogen in cervical necrotizing soft tissue infection.
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PMID:[A case of cervical necrotizing soft tissue infection]. 1457 26

We report a case of late perforation of the thoracic esophagus with an esophagopleural fistula after endoscopic sclerotherapy for esophageal varices in a Child-Pugh B9 cirrhotic patient. The existence of a thoracic empyema without diffuse mediastinitis allowed management of the fistula by percutaneous drainage-lavage and antibiotic therapy with subsequent closure of the esophageal wall defect and recovery from sepsis. This observation indicates that minimally invasive management of an esophageal perforation complicated by an esophago-pleural fistula is possible in highly selected patients.
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PMID:[Drainage-lavage and closure of a late esophageal perforation with esophagopleural fistula and encysted pleural effusion after endoscopic injection sclerotherapy for varices]. 1473 50


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