clove and Necrosis

Acute mediastinitis, also called descending necrotizing mediastinitis and cervicomediastinal necrotizing fasciitis, is a disease due to the spread of severe cervical or oropharyngeal infection. Our retrospective study examined clinical records of patients admitted to the surgical intensive care unit for the management of acute mediastinitis during the four-year period 2009-2012. The records showed 14 cases admitted during these four years. The patients' mean age was 30 years and 8 months, and the M/F sex-ratio was 1.33. The main predisposing factors found were the presence of a severe cervical infection, such as fasciitis, of odontogenic origin or the administration of anti-inflammatory drugs. The diagnosis is based on clinical data findings of thoracic pain with dyspnea or orthopnea, fever, or even septic shock and is confirmed by radiologic findings. The patient's multidisciplinary management combines medical management (supportive medical care in an intensive care unit and broad-spectrum antibiotic therapy) and surgical treatment by bilateral cervicotomy with mediastinal drainage. The mortality rate was high at 71.42%. In Madagascar, neglect of dental health can cause odontogenic fasciitis, which plays an important role in descending mediastinitis, a disease that still has a catastrophic prognosis today.

Topics: Acute Disease; Adolescent; Adult; Child; Child, Preschool; Female; Hospitals; Humans; Madagascar; Male; Mediastinitis; Mediastinum; Middle Aged; Necrosis; Retrospective Studies; Time Factors; Young Adult

Female genital tuberculosis is relatively frequent in developing countries. Most cases occur in young women of childbearing age. The most common locations are the tubes, endometrium, and ovaries. Bartholin gland involvement is rare. The purpose of this report is to present a case of Bartholin gland tuberculosis in a 50 year-old woman and to describe the special epidemiological, clinical and therapeutic features associated with this location. Bartholinitis develops insidiously until spontaneous fistula formation. The lesion then gradually assumes a vegetative appearance that persists despite antibiotic treatment. Diagnosis requires biopsy findings demonstrating the presence of granulomatous tissue with caseous necrosis. Patients respond favorably to specific medical treatment. The recent spread of human immunodeficiency virus has increased the need to continue and improve efforts to control turberculosis particularly in endemic zones.

Topics: Bartholin's Glands; Biopsy; Diagnosis, Differential; Female; Humans; Madagascar; Middle Aged; Necrosis; Tuberculosis, Female Genital