Descending necrotizing mediastinitis is believed to be a rare and serious complication of odontogenic and oropharyngeal infections. It is associated with a high (up to 40%) mortality rate, which can be attributed to delays in diagnosis and inadequate surgical drainage. Between May 1999 and September 2002, we treated 7 cases at our institution in New Delhi, indicating that such fulminating infections are not so rare in developing countries. In our 7 cases, a high index of suspicion and early computed tomography helped us make a rapid diagnosis and initiate prompt treatment, which resulted in a favorable outcome in 6 cases (mortality rate: 14.3%).
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IsaacsLM, KottonB, PeraltaMMJr., Fatal mediastinal abscess from upper respiratory infection. Ear Nose Throat J1993;72:620–2, 624–6,631.
