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.

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降低具有免疫功能的患者中由链球菌引起的坏死性纵隔炎：病例报告和文献复习

坏死性纵隔炎下降是纵隔的严重感染。该综合征表现为咳嗽和咳痰后发烧和胸痛。一名49岁的女性出现发烧，并有14天的肺炎病史。CT表现为纵隔脓肿，伴有巨大的钙化纵隔淋巴结（21×18 mm）和肺炎。在全身麻醉下通过EBUS-TBNA进行支气管镜检查。在穿刺培养物中发现的病原体是链球菌，并使用了抗生素（美洛西林/舒巴坦3.375 IVGTT q8h）。发现了一个近端右主支气管肿瘤，怀疑是肺癌，并符合炎症性肉芽肿。出院后总共22个月，患者临床稳定。