Staphylococcus aureus Descending Necrotizing Mediastinitis in a Healthy Adult

Descending necrotizing mediastinitis (DNM) is a severe form of mediastinitis with high mortality rates due to the rapid progression of infection into the mediastinum through tissue planes, often from a dental or pharyngeal source. We present a case of monomicrobial methicillin-resistant Staphylococcus aureus DNM in a healthy young man who was initially misdiagnosed with strep throat. This is well described in the pediatric literature; however, DNM in adults is typically polymicrobial and occurs in those with comorbidities such as diabetes mel-litus and older age. Survival is excellent with early identification of mediastinitis, prompt surgical interven-tion, and appropriate antibiotics. (C) 2021 by The Society of Thoracic Surgeons