The spread of infection through the danger space to the mediastinum case report

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Deep neck infection is an infection in the potential space and fascial planes of the neck, either with abscess formation or cellulitis. Cervical fascias create space and plane, which define and limit the spread of infection. Danger space is the area of thin connective tissue extending from the skull base down to the diaphragm. This space is enclosed on all sides, therefore inflammation in this area arises from penetration and spreads of infection from surrounding structures. This risk is in the rapid spread of infection in the chest, due to the low resistance of thin connective tissue. Formation of the descending necrotizing mediastinitis is the most common and most feared complication of danger space. Authors describe a case of extensive dental infection that despite intensive surgical and antibiotic treatement spread to other anatomical areas and caused descending necrotizing mediastinitis.


  • 1. Kang SK, Lee S, Kong Oh H., Kang MW, Hoon Na M., Hyeoun Yu J, Seok Koo B, Pyung Lim S. Clinical Features of Deep Neck Infections and Predisposing Factors for Mediastinal Extension. Korean J Thorac Cardiovasc Surg 2012; 7: 171-176.

  • 2. Vieria F, Allen SM, Stock RMS, Thompson JW. Deep Neck Infection. Otolaryngol Clin North Am 2008; 41: 459- 483.

  • 3. Som PM, Curtin HD. Fascia and Spaces of the Neck. Head and Neck imaging, 4th ed. St. Luis: Mosby; 2003 p. 1805-1827.

  • 4. Komínek P, Chrobok V, Astl J a kol. Záněty hltanu. 1st ed. Havlíčkúv Brod: Tobiáš; 2005 p. 251-256.

  • 5. Endo S, Murayama F, Hasegava T, Yamamoto S, Yamagutchi, T, Sohara Y, Fuse K, Miyata M, Nischino P. Guideline of Surgical Management Based on Diffusion of Descending Necrotizing Mediastinitis. Jpn J Thorac Cardiovasc Surg 1999; 47: 14-19.

  • 6. Banazedeh M, Eshraghi M, Bagher RM, Asghar AA, Kord V. Succesful Management of Acute Necrotizing Mediastinitis with Trans-cervical Drainage. Ann Thorac Cardiovasc Surg 2011; 17: 498-500.

  • 7. Pinto A, Scaglione M, Scuderi MG, Tortora G, Daniele S, Romano L. Infections of the neck leading to descending necrotizing mediastinitis: Role of multi-detector row computed tomography. Eur J Radiol 2008; 65: 389-394.

  • 8. Ho KL, Chen HL, Lin ChM. Acute descending mediastinitis secondary to an odontogenic infection in a pacient initially suspected of having acute thyroiditis. A case report. J Acute Medicine 2011; 1: 52-54.

  • 9. Yang SW, Lee MH, Lee YS., Huang SH, Chen TA, Fang TJ. Analysis of Life-Threatening Complications od Deep Neck Abscess and the Impact of Empiric Antibiotics. ORL J Otorinolaryngol Relat Spec 2008; 70(4): 249-256.

Acta Medica Martiniana

The Journal of Comenius University in Bratislava

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