Abstract
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.