title: Fulminant mediastinitis after goiter recurrence surgery: a case report.
abstract: BACKGROUND
  Necrotizing soft tissue infection is a life-threatening disease characterized by rapid progressive inflammation and necrosis of the subcutaneous and deep fascia with or without involvement of the adjacent muscles.
  
  
  METHODS
  We report the case of a 62-year-old Caucasian woman with goiter recurrence who underwent a right-sided hemithyroidectomy. Postoperatively, she developed fulminant mediastinitis caused by group A β-hemolytic streptococcus and septic shock. Our patient survived this rare life-threatening complication.
  
  
  CONCLUSIONS
  Initial atypical postoperative symptoms, such as personality changes or an unstable circulatory system, should lead a practitioner to consider the possibility of this severe complication and to begin therapy immediately.
authors.affiliation: University Hospital 'Carl Gustav Carus', Department of Trauma and Reconstructive Surgery, Fetscherstr, 74, 01307 Dresden, Germany. susanne.rein@web.de.
authors.forename: Susanne
authors.initials: S
authors.lastname: Rein
authors.forename: Martina
authors.initials: M
authors.lastname: Mittag-Bonsch