Descending Necrotizing Mediastinitis by Streptococcus anginosus and Prevotella buccae in an Intensive Care Unit Patient: A Case Report

Cureus. 2023 May 30;15(5):e39703. doi: 10.7759/cureus.39703. eCollection 2023 May.

Abstract

Necrotizing infections of deep neck spaces are a group of life-threatening infectious diseases acquired through trauma or as a descending infection from an odontogenic source. The isolation of pathogens is unusual because of the anaerobic nature of the infection; however, one way to achieve this is through the use of automated microbiological methods like matrix-assisted laser desorption/ionization and time-of-flight (MALDI-TOF) following standard microbiology protocols for analyzing samples from potential anaerobic infections. We present a case of a patient without risk factors for descending necrotizing mediastinitis with isolation of Streptococcus anginosus and Prevotella​​​​​​​ buccae managed at the intensive care unit with a multidisciplinary team. We present our approach and how we successfully treat this complicated infection.

Keywords: anaerobes; anaerobes of clinical importance; deep neck space infection; descending necrotizing mediastinitis; mediastinitis management; odontogenic infections; thoracic empyema; video-assisted thoracoscopic surgery (vats).

Publication types

  • Case Reports