A Case of Descending Necrotizing Mediastinitis Secondary to Cervical Necrotizing Fasciitis

Abstract

Cervical necrotizing fasciitis (CNF) is a progressive infection and easily leads to descending necrotizing mediastinitis (DNM), which is associated with high mortality rates. We report a case of a 68-year-old woman suffering from CNF with DNM. She showed renal and liver dysfunction and coagulopathy. She was treated with surgical debridement and drainage of the neck and mediastinum, antibiotic agents, and systemic management in the intensive care unit (ICU). Although she recoverd from DNM, severe dysphagia occurred due to postinflammatory scar formation. She was finally able to swallow after nine months of rehabilitation.

Active treatment with both surgery and medication is crucial for overcoming life-threatening CNF and DNM. However, severe inflamation and active surgical treatment may cause dysphagia. Therefore, it is important to monitor for dysphagia and start swallowing rehabilitation as soon as possilbe after recovery from the life-threatening phase of these diseases.