Abstract

Descending necrotizing mediastinitis is an aggressive infective entity which develops secondary to infection and/or abscess of head and neck and causes high mortality unless a prompt and appropriate therapy including antimicrobial management is attained. A descending necrotizing mediastinitis following dental abscess was diagnosed in a 48-year-old male based on plain chest radiography, computerized tomography of the thorax and the clinical status. An external drainage of neck abscess and debridement of thoracic abscess tissue via thoracotomy were accomplished. The tracheal fistula that was found during this procedure was closed successfully. The patient has been disease free during 12-month follow-up.