Abstract
A 71 year-old-female with shoulder and back pain and hematemesis was transferred to our hospital as an emergency. CT scans showed that an abscess of the left neck extended to the inferior mediastinum. On admission, she was treated with cervical and thoracic drainage and a large volume of matter was discharged from the abscess. αStreptococcus (group A) was detected with a culture test. Despite intensive care (chemotherapy, drainage, and so on), the patient died on the eleventh hospital day with multiple organ failure. Because of the deterioration of the respiratory system and the patient's poor general condition, we did not try mediastinal drainage with thoracotomy. If we had diagnosed Descending Necrotizing Mediastinitis (DNM) and tried early and aggressive drainage through a thoracotomy, there was some possibility that she might have survived the DNM. This report also includes a review of the relevant literature.
