Abstract
Descending necrotizing mediastinitis (DNM) is known to be a fatal illness resulting from oropharyngeall infections and which rapidly progresses to sepsis and multiple organ failure. Because of its virulence, delayed diagnosis and therapy are directly linked with high mortality. We must keep DNM in mind when treating a case with progressive oropharyngeal infectious disease. We report successful treatment of a DNM case. The patient recovered with thoracoscopic mediastinal drainage surgery. This patient had undergone cervical drainage surgery for a cervical abscess resulting from pharyngitis at another institution. However, his clinical condition deteriorated and DNM was diagnosed by computed tomography on postoperative day (POD) 7, followed by referral to our institution. The DNM extended into the posterior mediatinum below the carina. We performed thoracoscopic mediastinal drainage surgery, resulting in a good outcome. It is our experience that thoracoscopic mediastinal drainage is a good choice for DNM management because it is minimally invasive and efficacy is assured.
