tailieunhanh - báo cáo khoa học: " Fulminant mediastinitis after goiter recurrence surgery: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Fulminant mediastinitis after goiter recurrence surgery: a case report | Rein and Mittag-Bonsch Journal of Medical Case Reports 2010 4 364 http content 4 1 364 JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Fulminant mediastinitis after goiter recurrence surgery a case report Susanne Rein1 Martina Mittag-Bonsch2 Abstract Introduction Necrotizing soft tissue infection is a life-threatening disease characterized by rapid progressive inflammation and necrosis of the subcutaneous and deep fascia with or without involvement of the adjacent muscles. Case presentation We report the case of a 62-year-old Caucasian woman with goiter recurrence who underwent a right-sided hemithyroidectomy. Postoperatively she developed fulminant mediastinitis caused by group A p-hemolytic streptococcus and septic shock. Our patient survived this rare life-threatening complication. Conclusions Initial atypical postoperative symptoms such as personality changes or an unstable circulatory system should lead a practitioner to consider the possibility of this severe complication and to begin therapy immediately. Introduction Necrotizing soft tissue infection NSTI is a life-threatening disease characterized by rapid progressive inflammation as well as necrosis of the subcutaneous and deep fascia with or without involvement of the adjacent muscles. The prevalence of this disease is such that the average practitioner will see only one or two cases in his or her career 1 . NSTI of the head and neck is thus an extremely rare occurrence in modern medicine 2 . We report a case of NSTI after goiter recurrence surgery. Case presentation A 62-year-old Caucasian woman presented with a six year history of a growing mass in the right side of her neck. Our patient reported that she had had a euthyroid nodular goiter with a compensated autonomous adenoma and suppression of the residual thyroid 21 years previously. At that time a subtotal thyroid resection of both lobes was performed. The postoperative period was unremarkable. Clinical .