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We report the a successful intensive care of a 41-year-old man, who had facial and cervical cellulitis, descending necrotizing mediastinitis, and bilateral pyothorax caused by pericoronitis. Computed tomographic scans showed abscesses extending from the left temporal region and the neck to the mediastinum, with bilateral pleural effusion. Surgical drains were placed in the face, neck, and chest, and several types of antibiotics were administered intravenously. Pus cultures disclosed abundant growth ofStreptococcus constellatesandPrevotella intermedla. The patient received mechanical ventilation with a high concentration of oxygen. Our experience suggested that such severe cases require aggressive chemotherapy with a combination of antibiotics and surgical drainage by a multidisciplinary team of surgeons.

nihon koukuu geka gakkai zasshi/nippon kōkū geka gakkai zasshi

Successful treatment with intensive care of facial and cervical cellulitis, descending necrotizing mediastinitis, and bilateral pyothorax caused by pericoronitis: a case report