[A case of anterior mediastinal abscess with skin fistula resulting from descending necrotizing mediastinitis].

Descending necrotizing mediastinitis (DNM) is a serious, life-threatening infection. We present a case of anterior mediastinal abscess resulting from DNM. A 43-year-old woman, who had underwent cervical drainage for DNM 4 months ago, visited our hospital for cervical fistula. Chest CT revealed anterior mediastinal abscess. Mediastinal drainage through a subxiphoidal incision, debridement via the parasternal approach and resection of cervical fistula were performed without thoracotomy. A continuous mediastinal irrigation by acid water was performed postoperatively. The culture of the drain fluid became negative, and mediastinal abscess was disappeared. In conclusion, immediate and suitable drainage, debridement and postoperative-irrigation are important for DNM. On chronic stage, management to defend from extending infection is needed.