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

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.