DOI: 10.36347/sjmcr.2018.v06i02.010

Pages: 97-100

Descending necrotizing mediastinitis (DNM) is a rare, rapidly progressive complication of oropharyngeal infections that spreads deep into the mediastinum through loose retropharyngeal spaces, resulting in necrosis and destruction of the mediastinum structure. Recognition of unexpectedly wide-spreading infection in the mediastinum is difficult without appropriate CT imaging, and diagnosis is often delayed. We present a case of a 69-year-old man with DNM successfully treated with a multidisciplinary approach, including aggressive surgical debridement. The patient manifested diffuse ST-segment elevations in twelve-lead electrocardiogram on the day of admission. In our case, acute electrocardiogram changes were useful in early recognition of pericardial involvement and contributed to appropriate surgical debridement.