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Therapeutics and Clinical Risk Management Volume 14, 2018 - Issue
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Case Report

Descending necrotizing mediastinitis in a healthy young adult

Nobuaki Ochi1 Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan, [email protected]Correspondence[email protected]
,
Tokio Wakabayashi2 Department of Otolaryngology, Kawasaki Medical School, Okayama, Japan
,
Atsushi Urakami3 Department of General Surgery, Kawasaki Medical School, Okayama, Japan
,
Tomoki Yamatsuji3 Department of General Surgery, Kawasaki Medical School, Okayama, Japan
,
Naoto Ikemoto4 Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School, Okayama, Japan
,
Yasunari Nagasaki1 Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan, [email protected]
,
Nozomu Nakagawa1 Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan, [email protected]
,
Yoshihiro Honda1 Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan, [email protected]
,
Hidekazu Nakanishi1 Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan, [email protected]
,
Hiromichi Yamane1 Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan, [email protected]
,
Yasumasa Monobe5 Department of Pathology, Kawasaki Medical School, Okayama, Japan
,
Takeshi Akisada2 Department of Otolaryngology, Kawasaki Medical School, Okayama, Japan
,
Hiroshi Katayama4 Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School, Okayama, Japan
,
Yoshio Naomoto3 Department of General Surgery, Kawasaki Medical School, Okayama, Japan
&
Nagio Takigawa1 Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan, [email protected]
 show all
Pages 2013-2017 | Published online: 17 Oct 2018

Figures & data

Figure 1 (A) Chest X-ray on arrival; (B) electrocardiogram on arrival, indicating broad ST-elevation.

Figure 1 (A) Chest X-ray on arrival; (B) electrocardiogram on arrival, indicating broad ST-elevation.

Figure 2 (A) Coronal, (B) sagittal, and (C–H) axial chest CT images on arrival.

Note: A large volume of gas had collected (arrowhead) with an abscess (arrow) in the submandibular space, anterior neck space, and the upper and anterior mediastinum.
Figure 2 (A) Coronal, (B) sagittal, and (C–H) axial chest CT images on arrival.

Figure 3 Pathological findings of excised skeletal muscle and fascia.

Notes: (A–C) Acute inflammation with necrosis, consistent with necrotizing fasciitis; (D) Gram staining revealed a large number of Gram-positive cocci.
Figure 3 Pathological findings of excised skeletal muscle and fascia.

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