Cervical necrotizing fasciitis and descending necrotizing mediastinitis in a patient affected by neglected peritonsillar abscess: A case of medical negligence

Bono, Giovanna; Argo, Antonina; Zerbo, Stefania; Triolo, Valentina; Procaccianti, Paolo

doi:10.1016/j.jflm.2007.12.008

« Previous Next »Journal of Forensic and Legal Medicine
Volume 15, Issue 6 , Pages 391-394, August 2008

Cervical necrotizing fasciitis and descending necrotizing mediastinitis in a patient affected by neglected peritonsillar abscess: A case of medical negligence

Department of Legal Medicine, University of Palermo, Via Del Vespro, 127-90129 Palermo, Italy

Received 31 January 2007; received in revised form 4 September 2007; accepted 31 December 2007.

Abstract

We report a case of fatal cervical necrotizing fasciitis (CNF) and descending necrotizing mediastinitis (DNM) due to primary peritonsillar abscess in 60-year-old male patient with no history or evidence of immunocompromising disorders.

The patient was treated with antibiotic and corticosteroid drugs but he developed mediastinitis and septic shock and died of multiple organ failure six days later from recovery in hospital.

After a clinical, diagnostic and therapeutical consideration of the cervical necrotizing fasciitis and some related risks of a delayed diagnosis and treatment, the authors analysed the clinical history of the patient and of the medical conduct pointing out professional malpractice chargeable to doctors.

Keywords: Peritonsillar abscess, Cervical necrotizing fasciitis, Descending necrotizing mediastinitis, Medical negligence, Case report