Methicillin resistant Staphylococcus aureus infection in descending necrotizing mediastinitis from retropharyngeal perforation: a rare event.

BACKGROUND: Descending necrotizing mediastinitis is a rare but serious infection of the interpleural spaces and mediastinal connective tissue from the cervical region to the diaphragm that spreads rapidly along fascial planes. CASE: This report describes an unusual presentation of descending necrotizing mediastinitis in an otherwise healthy 25-year-old woman infected with methicillin-resistant Staphylococcus aureus, whose management required open sternotomy with frequent debridement. CONCLUSION: The mainstays of descending necrotizing mediastinitis management are early diagnosis, aggressive surgical debridement and drainage, and appropriate antibiotic therapy.