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Conservative Management of Acute Nontraumatic Mediastinitis in Children: A Case Series

Stacy Schertenleib1, Céline Callias2, Pierre Alex Crisinel3

  • 1Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, Lausanne 1011, Switzerland, unil.ch.

Case Reports in Pediatrics
|August 19, 2026
PubMed

Insights

Acute nontraumatic mediastinitis in children is rare. Conservative antibiotic therapy, without surgery, led to full recovery in four pediatric cases, suggesting a safe and effective management approach.

Area of Science:

  • Pediatric Medicine
  • Infectious Diseases

Background:

  • Acute nontraumatic mediastinitis is a rare, life-threatening condition.
  • Management strategies in pediatric cases are not standardized.

Purpose of the Study:

  • To describe four pediatric cases of acute nontraumatic mediastinitis.
  • To evaluate the effectiveness of conservative management in children.

Main Methods:

  • Case series of four pediatric patients with acute nontraumatic mediastinitis.
  • Diagnosis confirmed by CT scan and MRI.
  • Management included prolonged antibiotic therapy without surgical drainage.

Main Results:

  • Two cases originated from cervical infections (descending necrotizing mediastinitis).
  • Two cases had an indeterminate source, one associated with varicella and toxic shock syndrome.
  • All patients recovered completely without sequelae after conservative treatment.

Conclusions:

  • Conservative, antibiotic-based management can be safe and effective for selected pediatric patients with acute nontraumatic mediastinitis.
  • This approach avoids the need for surgical intervention in many cases.

Keywords:
acute nontraumatic mediastinitiscase seriesconservative managementdescending necrotizing mediastinitispediatric

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