[Descending Necrotizing Mediastinitis Survived by Two Operations;Report of a Case]

The patient, a 65-year-old woman, visited at her local doctor's office with the chief complaint of pharyngeal pain. After being administered antibacterial drugs, hyperthermia persisted and the pharyngeal pain became exacerbated. She was referred to our hospital and diagnosed as a retropharyngeal abscess and descending necrotizing mediastinitis (DNM). She was urgently hospitalized and surgery was performed. The mediastinal pleura was incised with thoracoscopic guidance and curettage, irrigation, and drainage were performed. Additional drainage was determined to be necessary based on findings from subsequent chest computed tomography and a prolonged inflammatory reaction. Therefore, on hospital day 7, 2nd surgery were performed, and tracheotomy was additionally performed with curettage of the neck abscess. The patient was taken off mechanical ventilation on hospital day 18, and discharged on hospital day 55.