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Descending necrotizing Mediastinitis caused by Kocuria rosea: a case report.

Lee MK, Choi SH, Ryu DW - BMC Infect. Dis. (2013)

Bottom Line: Kocuria species are gram-positive, non-pathogenic commensals.However, in immunocompromised patients such as transplant recipients, cancer patients, or patients with chronic medical conditions, they can cause opportunistic infections.Descending necrotizing mediastinitis due to Kocuria rosea can be successfully treated with prompt surgical drainage combined with antimicrobial therapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Wonkwang University, Shinyong-dong 344-2, Iksan, Jeonbuk, Republic of Korea. bart21@hanmail.net.

ABSTRACT

Background: Kocuria species are gram-positive, non-pathogenic commensals. However, in immunocompromised patients such as transplant recipients, cancer patients, or patients with chronic medical conditions, they can cause opportunistic infections.

Case presentation: We report the first case of descending necrotizing mediastinitis in a 58-year-old, relatively healthy woman caused by Kocuria rosea.

Conclusion: Descending necrotizing mediastinitis due to Kocuria rosea can be successfully treated with prompt surgical drainage combined with antimicrobial therapy.

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Related in: MedlinePlus

A computed tomography (CT) scan showing a large extended retropharyngeal abscess formation extending to the bronchial bifurcation.
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Figure 1: A computed tomography (CT) scan showing a large extended retropharyngeal abscess formation extending to the bronchial bifurcation.

Mentions: A 58-year-old woman presented to her local hospital with fever, myalgia, and sore throat. Her medical history was significant for gout and hypertension controlled with medications. After a few days of treatment, although her condition improved, she still complained of nausea, neck discomfort, and difficulty swallowing. Endoscopy revealed a gastric ulcer but no esophageal lesions. Ultrasound showed fluid collection in the neck space and a diagnosis of DNM was made by cervicothoracic computed tomographic (CT) scan. At that point, she was transferred to our hospital. On admission, she was afebrile with swelling of the neck and associated discomfort. She denied any other specific symptoms. Laboratory testing showed elevated levels of erythrocyte sedimentation rate (120 mm/h) and C-reactive protein (75.77 mg/L). The albumin level had decreased (3.2 g/dL) and she had a normal white blood cell count. The remaining laboratory values were within normal limits. A CT scan showed a large, retropharyngeal abscess extending from the surrounding piriform sinus to the bronchial bifurcation. No significant abnormality was seen in the pharynx and tonsils (FiguresĀ 1, 2).


Descending necrotizing Mediastinitis caused by Kocuria rosea: a case report.

Lee MK, Choi SH, Ryu DW - BMC Infect. Dis. (2013)

A computed tomography (CT) scan showing a large extended retropharyngeal abscess formation extending to the bronchial bifurcation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3852562&req=5

Figure 1: A computed tomography (CT) scan showing a large extended retropharyngeal abscess formation extending to the bronchial bifurcation.
Mentions: A 58-year-old woman presented to her local hospital with fever, myalgia, and sore throat. Her medical history was significant for gout and hypertension controlled with medications. After a few days of treatment, although her condition improved, she still complained of nausea, neck discomfort, and difficulty swallowing. Endoscopy revealed a gastric ulcer but no esophageal lesions. Ultrasound showed fluid collection in the neck space and a diagnosis of DNM was made by cervicothoracic computed tomographic (CT) scan. At that point, she was transferred to our hospital. On admission, she was afebrile with swelling of the neck and associated discomfort. She denied any other specific symptoms. Laboratory testing showed elevated levels of erythrocyte sedimentation rate (120 mm/h) and C-reactive protein (75.77 mg/L). The albumin level had decreased (3.2 g/dL) and she had a normal white blood cell count. The remaining laboratory values were within normal limits. A CT scan showed a large, retropharyngeal abscess extending from the surrounding piriform sinus to the bronchial bifurcation. No significant abnormality was seen in the pharynx and tonsils (FiguresĀ 1, 2).

Bottom Line: Kocuria species are gram-positive, non-pathogenic commensals.However, in immunocompromised patients such as transplant recipients, cancer patients, or patients with chronic medical conditions, they can cause opportunistic infections.Descending necrotizing mediastinitis due to Kocuria rosea can be successfully treated with prompt surgical drainage combined with antimicrobial therapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Wonkwang University, Shinyong-dong 344-2, Iksan, Jeonbuk, Republic of Korea. bart21@hanmail.net.

ABSTRACT

Background: Kocuria species are gram-positive, non-pathogenic commensals. However, in immunocompromised patients such as transplant recipients, cancer patients, or patients with chronic medical conditions, they can cause opportunistic infections.

Case presentation: We report the first case of descending necrotizing mediastinitis in a 58-year-old, relatively healthy woman caused by Kocuria rosea.

Conclusion: Descending necrotizing mediastinitis due to Kocuria rosea can be successfully treated with prompt surgical drainage combined with antimicrobial therapy.

Show MeSH
Related in: MedlinePlus