A case of cervical cellulitis and mediastinitis developing from odontogenic infection

The authors report a case of cervical cellulitis and mediastinitis developing from odontogenic infection.A 52-year-old woman visited our clinic because of dyspnea and pain on swallowing. She was given a diagnosis of cervical cellulitis caused by an odontogenic infection of the lower left second and third molars. We administered antibiotics and extracted the lower left second and third molars. However, the patient's condition deteriorated, and the inflammation spread to the contralateral side. Four days later, surgical drainage of the left submental and submandibular regions was performed under general anesthesia.Despite this surgical procedure, a postoperative computed tomographic (CT) scan revealed anterosuperior mediastinitis and thrombosis extending from the right subclavian vein to the brachiocephalic vein. Therefore, transcervical mediastinal drainage, thrombolytic therapy, and placement of a vena cava filter were performed. Subsequently, the patient recovered uneventfully.Our experience indicates that it is important to accurately diagnose rapidly developing lesions and to promptly perform surgery when severe odontogenic infection is encountered.