Title:Descending Necrotizing Mediastinitis: Current Strategies for Diagnosis and Treatment
VOLUME: 8 ISSUE: 4
Author(s):Richard K. Freeman, Theresa Giannini, Amy Vyverberg and Anthony J. Ascioti
Affiliation:Department of Thoracic and Cardiovascular Surgery, St Vincent Hospital, 8433 Harcourt Road, Indianapolis, Indiana 46260, USA.
Keywords:Descending, mediastinitis, necrotizing, polymicrobial infection, tissue necrosis, PATHOPHYSIOLOGY, cervicofascial infection, computed tomographic imaging, chest roentgenograms, modern.
Abstract:Descending necrotizing mediastinitis is an acute, polymicrobial infection. Originating in the pharynx or neck,
this necrotizing process descends into the chest producing widespread tissue necrosis. Despite the introduction of modern
antimicrobial therapy and computed tomographic imaging, this form of mediastinitis has continued to produce reported
mortality rates of 25% to 40%. This review discusses the pathophysiology, diagnosis and treatment of descending
necrotizing mediastinitis with recommendations for treating physicians based on the modern literature.