Descending necrotizing mediastinitis in early childhood: favorable outcome after aggressive treatment.

ABSTRACT

OBJECTIVE: To report a case of descending necrotizing mediastinitis (DNM), an unusual illness in childhood that develops as a complication of oropharyngeal infection. DESIGN: Descriptive case report. SETTING: Pediatric intensive care unit. PATIENT A 19-month-old boy with a DNM that resulted from a pharyngeal abscess. INTERVENTIONS: Aggressive surgical debridement; intravenous therapy with broad-spectrum antibiotics. MEASUREMENTS AND MAIN RESULTS: Simple chest radiograph and computed tomographic scan, and routine culture were used to assess the patient. Administration of broad-spectrum antibiotics and surgical drainage resulted in clinical resolution of symptoms. CONCLUSIONS: An aggressive approach (broad-spectrum antibiotics and surgical debridement) can improve the prognosis of DNM in children.