• Francis J Caputo, Louis J Magnotti, Carl J Hauser, and David H Livingston.
• Department of Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey, USA.
• Surg Infect (Larchmt). 2007 Dec 1;8(6):611-4.

BackgroundCentral venous catheter placement is a common procedure in the intensive care unit. However, these devices are not without complications. We describe the first reported case of descending necrotizing mediastinitis secondary to central venous catheterization without evidence of associated vascular perforation.MethodsCase report and literature review.ResultsA 24-year-old man developed descending necrotizing mediastinitis after exploratory laparotomy for a gunshot wound. A central venous catheter was presumed to be the source because blood, intraoperative, and catheter tip cultures grew the same Klebsiella organism, and there was no evidence of venous perforation at the initial operation.ConclusionsPrompt recognition, adequate operative drainage, and appropriate antibiotics remain the best treatment for descending necrotizing mediastinitis.

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