2023 Volume 37 Issue 2 Pages 105-111
Descending necrotizing mediastinitis (DNM) is a disease caused by oropharyngeal infection and is associated with a high mortality rate. We report a case of DNM with bilateral empyema, acute pericarditis, esophageal stenosis, and laryngeal dysfunction. A 41-year-old man was transported to our hospital complaining of chest pain after a sore throat persisting for a week. Computed tomography showed abscesses with air from the left tonsil to periesophageal area and bilateral pleural effusions. We diagnosed the patient with DNM with bilateral empyema. Consequently, two operations were required during the course of treatment. Acute pericarditis was confirmed on admission, and pericardial drainage was required on day 11 owing to obstructive shock with increased pericardial effusion. Because scarring around the larynx and esophagus was caused by the spreading inflammation in the subacute stage, dysphagia with poor opening of the esophageal orifice and poor laryngeal elevation were recognized. Rehabilitation with esophageal ballooning was effective. In cases of DNM, various complications could appear according to spreading inflammation; therefore, timely and appropriate treatment is important.
