Abstract
BackgroundKocuria species are gram-positive, non-pathogenic commensals. However, in immunocompromised patients such as transplant recipients, cancer patients, or patients with chronic medical conditions, they can cause opportunistic infections.Case presentationWe report the first case of descending necrotizing mediastinitis in a 58-year-old, relatively healthy woman caused by Kocuria rosea.ConclusionDescending necrotizing mediastinitis due to Kocuria rosea can be successfully treated with prompt surgical drainage combined with antimicrobial therapy.
Highlights
We report here the first case of Descending necrotizing mediastinitis (DNM) associated with K. rosea in a relatively healthy woman
The primary origin of a deep cervical infection is mostly unknown, it can be caused by an odontogenic infection, acute tonsillitis, a peritonsillar abscess, cervical lymphadenitis, sinusitis, or cervical trauma [4,5]
Kocuria rosea comprises the normal flora in the oropharynx, skin, and mucosa
Summary
Descending necrotizing mediastinitis (DNM) is an acute form of mediastinitis caused by odontogenic or deep cervical infections such as tonsillitis and pharyngitis that descend into the mediastinum and pleural space through the cervical fascial planes [1]. Kocuria rosea is an aerobic, gram-positive coccus that is generally considered as a non-pathogenic commensal that colonizes the oropharynx, skin, and mucosa. It can cause an opportunistic infection in immunocompromised patients [3]. Cervical drainage and irrigation were performed in order to drain the remaining neck abscess. The patient was discharged after 16 days of antibiotic therapy consisting of a third-generation cephalosporin and clindamycin. She has been followed up for 6 months and remains asymptomatic till date. Performed using chocolate (Reduced) agar with an anaerobic pouch and thioglycollate broth and incubated at 35°C for 5 days.
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