颈部间隙感染合并纵隔脓肿的临床特点及预后影响因素分析OA

OBJECTIVE Neck space infection complicated by mediastinal abscess is a life-threatening condition with high mortality,typically arising from the spread of head and neck infections to the mediastinum.This study analyzes prognostic factors through case reviews.METHODS We retrospectively reviewed the treatment courses of 5 patients with neck space infection and mediastinal abscess admitted to Beijing Tongren Hospital,Capital Medical University,from May 2024 and June 2025,to explore the key prognostic factors.RESULTS Three patients recovered after combined neck/mediastinal abscess drainage and targeted antibiotics.Two patients died due to severe systemic conditions(>70 years,uncontrolled diabetes,extensive abscesses involving lower/posterior mediastinum,and Gram-negative(G-)bacterial infections).These patients developed respiratory failure,sepsis,and multiorgan dysfunction despite ICU care.All three survivors were non-diabetic,including two younger patients(42 and 44 years)with Gram-positive(G+)infections and localized abscesses.Both non-survivors were elderly(≥70 years)with Gram-negative(G-)infections and extensive abscess dissemination.CONCLUSION Poor prognosis correlates with age>70 years,diabetes,extensive abscesses(especially in lower/posterior mediastinum),and G-infections.Multidisciplinary management emphasizing airway control,early surgical intervention,and culture-guided antibiotics is critical.