Descending necrotizing mediastinitis caused by Streptococcus constellatus in an immunocompetent patient: case report and review of the literature.
Descending necrotizing mediastinitis is a severe infection of the mediastinum. This syndrome manifests as fever and chest pain following cough and sputum production. A 49-year-old woman presented with fever and a 14-day history of pneumonia. CT showed mediastinal abscesses with a giant calcified mediastinal lymph node (21 × 18 mm) and pneumonia. Bronchoscopy by EBUS-TBNA under general anesthesia was performed. The pathogen found in the puncture culture was Streptococcus constellatus, and antibiotics (mezlocillin/sulbactam 3.375 IVGTT q8h) was administered. A proximal right main bronchial neoplasm, suspected lung cancer, was found and conformed to inflammatory granuloma. A total of 22 months post-discharge the patient was clinically stable. We also conducted a review of the literature for all Streptococcus constellatus descending necrotizing mediastinitis infections between 2011 and 2017.
['Ye|Rui-Hai|RH|', 'Yang|Jun-Chao|JC|', 'Hong|Hui-Hua|HH|', 'Mao|Yu-Ping|YP|', 'Zhu|Yuan-Hong|YH|', 'Cao|Yu|Y|', 'Wang|Zhen|Z|']
D000900:Anti-Bacterial Agents D001999:Bronchoscopy D004322:Drainage D005260:Female D006801:Humans D007121:Immunocompetence D008198:Lymph Nodes D008480:Mediastinitis D008875:Middle Aged D011014:Pneumonia D013290:Streptococcal Infections D034365:Streptococcus constellatus D014057:Tomography, X-Ray Computed
Descending necrotizing mediastinitis Streptococcus constellatus Calcified mediastinal lymph node EBUS-TBNA