Necrotizing Mediastinitis Following Rabbit Bone Ingestion: A Case Report

Abstract

Necrotizing mediastinitis is the most lethal type of mediastinitis and is caused by neck fascia, esophageal, and mediastinal infections. Therefore, its early diagnosis is crucial. This report presents the case of a 49-year-old man who was suffering from necrotizing mediastinitis due to prolonged esophageal rupturing after rabbit bone ingestion diagnosed using infection assessments and imaging. After right lateral posterior thoracotomy, the mediastinal abscess was debrided and drained. The rabbit bones were then removed from the esophagus. Two drainage tubes and two thoracotomy tubes were inserted into the mediastinal and pleural spaces, and a jejunostomy tube was inserted. Varied clinical manifestations makes the diagnosis hard and time-consuming. If early diagnosis, antibiotic therapy, thoracic surgery, proper monitoring, CT-scan imaging for differential diagnosis, and intervention are not initiated promptly, mediastinitis resulting from DNM can be lethal.