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A comprehensive review of the current data of descending necrotizing mediastinitis in <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>apan was carried out using <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>ub<jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>ed and <jats:styled-content style=\"fixed-case\">ICHUSHI<\/jats:styled-content> from the last 5\u2009years. The symptoms, origins, comorbid conditions, treatment modalities, complications, and survival rates were analyzed. Tonsillar and pharyngeal origin was more identified compared to odontogenic origin. More than one\u2010third of patients were diabetic and 28% of them were not identified as having any comorbidity. Streptococcus sp. and anaerobes were most isolated, reflecting the microflora of the oral cavity. Of the broad antibiotics, carbapenem was the most used as treatment, and clindamycin was the most co\u2010given. Mediastinal drainage approach varied widely and the optimal approach is controversial. Twenty\u2010one patients were treated with video\u2010assisted thoracic surgical drainage and 15 cases by percutaneous catheter drainage, whereas transcervical approach was applied in 25 patients and thoracotomy was carried out in 21 patients. The overall mortality was 5.6%. Many authors advocated that the most effective management tool is a high degree of clinical suspicion followed by prompt and adequate drainage with intensive care including hemodynamic and nutritional support and repeat computer tomographic monitoring.<\/jats:p>","DOI":"10.1002\/ams2.56","type":"journal-article","created":{"date-parts":[[2014,6,26]],"date-time":"2014-06-26T07:44:15Z","timestamp":1403768655000},"page":"1-12","source":"Crossref","is-referenced-by-count":60,"title":["Descending necrotizing mediastinitis: 5 years of published data in <scp>J<\/scp>apan"],"prefix":"10.1002","volume":"2","author":[{"given":"Yuka","family":"Sumi","sequence":"first","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Juntendo University, Urayasu Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,6,26]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-193810000-00009"},{"key":"e_1_2_15_3_1","first-page":"545","article-title":"Descending necrotizing mediastinitis","volume":"157","author":"Estrera AS","year":"1983","journal-title":"Surg. 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