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Article in Japanese

Descending necrotizing mediastinitis caused by Panton-Valentine leucocidin positive methicillin-susceptible Staphylococcus aureus in an immunocompetent child

Kenichi TAKESHITA1,2), Tadashi HOSHINO1), Chie FUKASAWA1), Naoki SHIMOJO2)

Descending necrotizing mediastinitis (DNM) is a rare disease in immunocompetent children. An 11-month-old previously healthy female was treated with DNM. She was admitted to this hospital complaining of fever and impaired consciousness. A contrast CT scan revealed retropharyngeal and mediastinal abscesses, and left pleural empyema. In addition to optimal antibiotics, aggressive surgical debridement of necrotic mediastinal tissues was achieved, and she was treated successfully. Panton-Valentine leucocidin gene positive methicillin-susceptible Staphylococcus aureus was isolated from a throat swab, blood, pleural fluid, and removed necrotizing tissue cultures. Laboratory tests for immunodeficiency screening were all normal. It is important to consider both host immune status and bacterial microbial toxicity in order to understand the cause of severe infection.

1) Division of Infectious Diseases, Chiba Children's Hospital
2) Department of Pediatrics, Graduate School of Medicine, Chiba University

Key words descending necrotizing mediastinitis, Staphylococcus aureus, PVL, immunocompetent child
Received June 14, 2018
Accepted January 6, 2019

31 (2):131─136,2019