<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1012-2966</journal-id>
<journal-title><![CDATA[Gaceta Médica Boliviana]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Med Bol]]></abbrev-journal-title>
<issn>1012-2966</issn>
<publisher>
<publisher-name><![CDATA[Facultad de Medicina de la Universidad Mayor de San Simón]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1012-29662022000100069</article-id>
<article-id pub-id-type="doi">10.47993/gmb.v45i1.371</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Mediastinitis Necrotizante Descendente de Origen Dental]]></article-title>
<article-title xml:lang="en"><![CDATA[Descending Necrotizing Mediastinitis of Dental Origin]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rayza Stefany]]></surname>
<given-names><![CDATA[Alejandro-Ibañez]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rommer Alex]]></surname>
<given-names><![CDATA[Ortega-Martínez]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,C.N.S. Hospital Obrero N°6 Medicina Interna]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Caja Nacional de Salud Hospital Obrero Nro. 2 ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2022</year>
</pub-date>
<volume>45</volume>
<numero>1</numero>
<fpage>69</fpage>
<lpage>74</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_arttext&amp;pid=S1012-29662022000100069&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_abstract&amp;pid=S1012-29662022000100069&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_pdf&amp;pid=S1012-29662022000100069&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El tratamiento inoportuno de las infecciones odontogénicas se acompaña de una complicación mortal, la mediastinitis necrotizante descendente aguda (MNDA), definida como una inflamación de los tejidos conectivos y las estructuras dentro del mediastino. La mortalidad es de aproximadamente del 11% al 41%, por sepsis e insuficiencia orgánica. Las decisiones médicas son decisivas porque el diagnóstico y el retraso del tratamiento son los cofactores primordiales relacionados con la mortalidad. El tratamiento quirúrgico precoz es el aspecto más importante en su manejo, necesitando en muchos casos, tratamiento en la unidad de cuidados intensivos (UTI). Se expone el caso clínico de un paciente masculino de 39 años, diabético, que ingresó a urgencias por un absceso odontógeno de 4 días de evolución. Tras los exámenes complementarios se constata un proceso inflamatorio que se extendía desde el piso de la boca hasta el mediastino, compatible con un MNDA; requirió varias intervenciones quirúrgicas y manejo en UTI más de 30 días con evolución favorable y posterior alta.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The untimely treatment of odontogenic infections is accompanied by a life-threatening complication, acute descending necrotizing mediastinitis (ADNDM), defined as an inflammation of the connective tissues and structures within the mediastinum. The mortality is approximately 11% to 41%, caused by sepsis and organ failure. Medical decisions are critical because diagnosis and treatment delay are the primary cofactors associated with mortality. Early surgical treatment is the most important aspect in the management, requiring, in most cases, treatment in the intensive care unit (ICU). We present the clinical case of a 39-year-old male patient, diabetic, who was admitted to the emergency room for a dental abscess with 4 days of evolution. After the complementary examinations, an inflammatory process was confirmed that extended from the floor of the mouth to the mediastinum, compatible with an MNDA; the patient required several surgical interventions and management in ICU for more than 30 days with favorable evolution and subsequent discharge.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[infección focal dental]]></kwd>
<kwd lng="es"><![CDATA[mediastinitis]]></kwd>
<kwd lng="es"><![CDATA[mediastino]]></kwd>
<kwd lng="en"><![CDATA[dental focal infection]]></kwd>
<kwd lng="en"><![CDATA[mediastinitis]]></kwd>
<kwd lng="en"><![CDATA[mediastinum]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tarelo-Saucedo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mediastinitis necrosante descendente: reporte de caso y revisión de la literatura]]></article-title>
<source><![CDATA[Cir Cardiov]]></source>
<year>2021</year>
<volume>28</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>106-12</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guerrero Pabón]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Torres Delgado]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mediastinitis]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Montejo González]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[García de Lorenzo y Mateos]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Marco Garde]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Ortiz Leyva]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
</person-group>
<source><![CDATA[Manual de medicina intensiva]]></source>
<year>2012</year>
<edition>4</edition>
<publisher-loc><![CDATA[Madrid ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Robles-Pérez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Córdova-López]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[López-Rodríguez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores que inciden en la mortalidad de la Mediastinitis aguda necrosante descendente]]></article-title>
<source><![CDATA[Rev Hosp Jua Mex]]></source>
<year>2018</year>
<volume>85</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>127-35</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pastene]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mediastinitis en el paciente de la unidad de cuidados intensivos: una revisión narrativa]]></article-title>
<source><![CDATA[Microbiología clínica e infección]]></source>
<year>2020</year>
<volume>26</volume>
<numero>2020</numero>
<issue>2020</issue>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moreno]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[Efectos de la mediastinitis necrotizante descendiente en pacientes con abscesos dentarios]]></source>
<year>2019</year>
<publisher-name><![CDATA[Universidad de Guayaquil, Facultad de Odontología]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Primitivo]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mediastinitis]]></article-title>
<source><![CDATA[Arch Bronconeumol]]></source>
<year>2011</year>
<volume>47</volume>
<numero>^s8</numero>
<issue>^s8</issue>
<supplement>8</supplement>
<page-range>32-6</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oropesa]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mediastinitis necrotizante descendente. Comunicación de dos casos y revisión de la literatura]]></article-title>
<source><![CDATA[Cuad. Cir.]]></source>
<year>2006</year>
<volume>20</volume>
<page-range>59-63</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Abboud]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Wey]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
<name>
<surname><![CDATA[Baltar]]></surname>
<given-names><![CDATA[VT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors for mediastinitis after cardiac surgery]]></article-title>
<source><![CDATA[Ann Thorac Surg]]></source>
<year>2004</year>
<volume>77</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>676-83</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Boscolo-Rizzo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Marchiori]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Montolli]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Vaglia]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Da Mosto]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Deep neck infections: a constant challenge]]></article-title>
<source><![CDATA[ORL J Otorhinolaryngol Relat Spec]]></source>
<year>2006</year>
<volume>68</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>259-65</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Giraldo]]></surname>
<given-names><![CDATA[A. M.]]></given-names>
</name>
<name>
<surname><![CDATA[Ucros]]></surname>
<given-names><![CDATA[Enrique Carlos]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dolor torácico: Más allá de un síndrome coronario]]></article-title>
<source><![CDATA[Rev. Méd. Risaralda]]></source>
<year>2015</year>
<volume>21</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>68-72</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Angulo-Camacho]]></surname>
<given-names><![CDATA[C.A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mediastinitis]]></article-title>
<source><![CDATA[South Am J Torca Surg]]></source>
<year>2002</year>
<volume>8</volume>
<page-range>2-6</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Angulo-Camacho]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fístula Esófagopleura]]></article-title>
<source><![CDATA[Salud Bol]]></source>
<year>2002</year>
<volume>14</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>56-9</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Angulo-Camacho]]></surname>
<given-names><![CDATA[C.A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mediastinitis]]></article-title>
<source><![CDATA[Cirugía de Tòrax Manual]]></source>
<year>2017</year>
<page-range>95-100</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
