Abstract
We report a 34-year-old female with deep neck infection extending into disseminated intravascular coagulation (DIC), septic shock, and descending necrotizing mediastinitis (DNM). The origin of infection was right mandibular dental caries. The patient was successfully treated with antibiotics, steroids, γ-globulin, and emergency surgical treatment. The surgery consisted of cervical drainage and mediastinal drainage without thoracostomy. Continuous irrigation was performed after the operation in the intensive care unit. DNM is recently a rare inflammatory lesion due to the development of antibiotics. Due to the difficulty of detecting the disorder, it takes a serious clinical course even if intensive care is given. For the diagnosis of DNM, it is necessary to check a chest X-ray film and a computed tomography scan of the mediastinum. Once a diagnosis is established, it is essential to perform adequate surgical drainage immediately and begin intensive systemic care.
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