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

Pediatr Crit Care Med. 2003 Oct;4(4):476-9. doi: 10.1097/01.PCC.0000074277.07221.38.


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.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnosis
  • Abscess / drug therapy*
  • Abscess / surgery*
  • Anti-Bacterial Agents / therapeutic use*
  • Debridement*
  • Humans
  • Infant
  • Male
  • Mediastinitis / drug therapy*
  • Mediastinitis / pathology
  • Mediastinitis / surgery*
  • Necrosis


  • Anti-Bacterial Agents