ナカミゾ　ムネナガ   中溝　宗永    所属   医学部 医学科（東京女子医科大学病院）    職種   特任教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Descending necrotizing mediastinitis associated with Lactobacillus plantarum.
掲載誌名	正式名：BMC infectious diseases 略　 称：BMC Infect Dis ISSNコード：14712334/14712334
掲載区分	国外
巻・号・頁	13,pp.398
著者・共著者	Nei Takahito, Inai Shunta, Mikami Iwao, Sato Akira, Okamoto Junichi, Yokoshima Kazuhiko, Nakamizo Munenaga, Haraguchi Shuji, Sonobe Kazunari, Saito Ryoichi
発行年月	2013/08
概要	BACKGROUND:Descending necrotizing mediastinitis (DNM), a severe infection with a high fatality rate, develops in mediastinal spaces due mainly to deep cervical abscesses. The majority of causative microbes of DNM are Streptococci and oral anaerobes. DNM associated with Lactobacillus-infection is rather rare.CASE PRESENTATION:A 69-year-old male with an unremarkable past medical history was referred to our hospital for surgical resection of advanced laryngeal cancer. Full examination revealed a neck abscess and DNM with a background of untreated diabetes mellitus. Initially, he was treated with meropenem. However, Lactobacillus plantarum was isolated from surgical drainage of a mediastinal abscess. Despite using antibiotics capable of eradicating all isolates with susceptibilities not differing significantly from those of the neck and mediastinal abscesses, we attributed DNM to the L. plantarum detected only in the mediastinal abscess. After DNM treatment, he underwent total pharyngolaryngectomy with bilateral neck dissection followed by reconstruction using free jejunum. He was discharged fully recovered.CONCLUSION:We concluded that L. plantarum as the sole cause of the mediastinal abscess in the present case cannot be ruled out. As the number of immunocompromised patients increases, we should be cautious regarding this "familiar" microbe.
DOI	10.1186/1471-2334-13-398
PMID	23987907