Öz
Desendan nekrotizan mediastinit (DNM), aerop ve anaerop bakterilerle oluşan, odontojenik enfeksiyonlara sekonder gelişen orofaringeal apselerin nadir fakat ciddi bir komplikasyonudur. Beta-laktam antibiyotiklere karşı hipersensitivite reaksiyonu olan hastalarda tedavisi zordur. Bildiğimiz kadarıyla, İngilizce tıbbi literatürde şu ana kadar, tigesiklin ile tedavi edilen sadece iki postoperatif mediastinit olgusu bildirilmiştir. Bu yazıda, diş çekiminden bir hafta sonra gelişen bir DNM olgusu sunmaktayız. Komplike derin boyun enfeksiyonuyla başlayıp desendan mediastinite ilerleyen olguda, beta-laktam grubu antimikrobiyallere ciddi allerjik reaksiyon nedeniyle tigesiklin verilmiştir. Erken cerrahi drenaj ve debridman ve dört haftalık tigesiklin tedavisi ile hasta tamamen iyileşmiştir. Beta-laktam antibiyotiklere allerjisi olan hastalarda odontojenik enfeksiyonlar ve desendan mediastinitin tedavisinde tigesiklin alternatif bir ajan olabilir. Özellikle, ciddi hipersensitivite reaksiyonu olan seçilmiş hastalarda, eş zamanlı standart erken cerrahi müdahale ile birlikte kullanımı etkili ve başarılı olabilir.
Anahtar Kelimeler: Desendan nekrotizan mediastinit, odontojenik, beta-laktam allerjisi, hipersensitivite reaksiyonu, tigesiklin
Kaynakça
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