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


CONCLUSIONS
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.
Department of Surgery, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada. yves.collin@usherbrooke.ca
Yves
Y
Collin
Marco
M
Sirois
Alex
A
Carignan
Jeffrey Charles
JC
Lawton Wackett
D005260:Female; D006801:Humans; D008478:Mediastinal Emphysema / Q000382:microbiology; D008480:Mediastinitis / Q000382:microbiology*; D008482:Mediastinum / Q000473:pathology*; D008875:Middle Aged; D009336:Necrosis; D011183:Postoperative Complications / Q000382:microbiology; D013290:Streptococcal Infections; D013297:Streptococcus pyogenes; D013965:Thyroidectomy / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed