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- David Claveau and Marie-Josée Bériault.
- Department of Emergency Medicine, Centre de santé et de services sociaux de Trois-Rivières, Centre hospitalier affilié universitaire régional, Trois-Rivières, Quebec, Canada.
- J Emerg Med. 2014 Jul 1;47(1):12-4.
BackgroundCardiac tamponade from necrotizing descending mediastinitis is a rare but life-threatening complication of cervicofacial infections.Case ReportA 49-year-old woman presented in shock with pleuretic chest pain at a small community clinic. She was transferred to our emergency department where cardiac tamponade was diagnosed and drained. Her initial complete blood count and chest radiography suggested a neoplastic process. She, however, was diagnosed with descending necrotizing mediastinitis due to group A Streptococcus. She underwent surgical drainage and recovered uneventfully. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Descending necrotizing mediastinitis can present with cardiac tamponade and a leukemoid reaction mimicking a neoplastic process. Recognizing this entity allows initiation of potentially life-saving treatments.Copyright © 2014 Elsevier Inc. All rights reserved.
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