Descending Necrotizing Mediastinitis: A Rare Yet Lethal Complication Demanding Timely Intervention

Overview

Journal Cureus

Date 2025 Jan 28

PMID 39872580

Authors

Anastasia Kosmidou

Panagiota Kosmidou

Ioannis Karamatzanis

Eleni Flari

Sofia Pouriki

Panagiotis K Nikolopoulos

Affiliations

Soon will be listed here.

Abstract

Descending necrotizing mediastinitis (DNM) is a rare and potentially life-threatening condition characterized by the rapid spread of infection within the mediastinum. This severe form of mediastinitis poses a significant challenge to clinicians due to its aggressive nature and potential for rapid deterioration. In this case report, we present a challenging case of descending necrotizing mediastinitis in a 39-year-old patient with persistent pyrexia and an extended hospital stay in the intensive care unit (ICU), cardiothoracic unit (CTU), and surgical intensive care unit (SICU). The step-by-step clinical course, diagnostic challenges, and therapeutic strategies will be discussed in detail. This case highlights the importance of early recognition and a comprehensive, interdisciplinary approach in managing this rare yet lethal mediastinitis.

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