Group A Streptococcus causing descending necrotizing mediastinitis: report of a case and literature review

Abstract

Background: Descending necrotizing mediastinitis is a serious condition with few cases reported in the literature. Surgical treatment is controversial and may include wound exploration, local drainage, and even mediastinal debridement approached by thoracotomy.

Methods: Description of a case of descending mediastinitis caused by group A Streptococcus as a complication of thyroidectomy.

Results: Aggressive debridement was required for source control and treatment of septic shock.

Conclusion: Post-thyroidectomy descending necrotizing mediastinitis is a rare and dangerous infection. It should be treated aggressively with appropriate cervical and mediastinal drainage combined with optimum medical care.