Abstract
A 41-year-old man complained of cough, back pain, and fever. Chest X-ray and computed tomographic (CT) scan showed enlargement of mediastinal shadow, bilateral pleural effusions, and pericardial effusion. He was diagnosed with mediastinitis and referred to our department. Then, through a right thoracotomy, debridement and drainage were performed. After operation, in spite of drainage and administration of antibiotics, fever continued. On hospital day 10, therefore, we started mediastinal lavage. After lavage, culture of the drain fluid became negative, and he was discharged on hospital day 63. Descending necrotizing mediastinitis is a rare and lethal disease. CT scan is useful for early diagnosis, and aggressive and adequate drainage is required. In our experience, aggressive mediastinal drainage by a thoracotomy approach and mediastinal lavage are recommended.
