A Fatal Aortic Arch Rupture Due to Descending Necrotizing Mediastinitis in a 24-year-old Woman

Vasc Endovascular Surg. 2017 Aug;51(6):408-412. doi: 10.1177/1538574417715193. Epub 2017 Jun 15.

Abstract

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.

Keywords: Prevotella buccae; aortic rupture; cervical necrotizing fasciitis; descending necrotizing mediastinitis.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / microbiology*
  • Aorta, Thoracic / surgery
  • Aortic Rupture / diagnostic imaging
  • Aortic Rupture / microbiology*
  • Aortic Rupture / therapy
  • Bacteroidaceae Infections / complications
  • Bacteroidaceae Infections / diagnosis
  • Bacteroidaceae Infections / microbiology*
  • Bacteroidaceae Infections / therapy
  • Debridement
  • Drainage
  • Fatal Outcome
  • Female
  • Focal Infection, Dental / complications
  • Focal Infection, Dental / diagnosis
  • Focal Infection, Dental / microbiology*
  • Focal Infection, Dental / therapy
  • Humans
  • Mediastinitis / diagnosis
  • Mediastinitis / microbiology*
  • Mediastinitis / therapy
  • Molar, Third / microbiology*
  • Molar, Third / surgery
  • Necrosis
  • Prevotella / isolation & purification*
  • Thoracotomy
  • Tomography, X-Ray Computed
  • Tooth Extraction
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents