Descending necrotizing mediastinitis secondary to retropharyngeal abscess

Authors

  • Sarah M Nwia Department of Radiology, Tulane University School of Medicine, New Orleans, USA
  • Christian D Huebner Department of Radiology, Tulane University School of Medicine, New Orleans, USA
  • Jeremy B. Nguyen Department of Radiology, Tulane University School of Medicine, New Orleans, USA

DOI:

https://doi.org/10.3941/jrcr.v17i8.5095

Keywords:

case report, CT, mediastinitis

Abstract

We report a case of descending necrotizing mediastinitis (DNM) in a 68-year-old male who presented in acute respiratory distress accompanied with anterior cervical neck swelling and pain with swallowing. Contrast enhanced computed tomography (CECT) of the neck demonstrated a large, peripherally enhancing retropharyngeal fluid and air collection that appeared to communicate with a fluid and air collection within the mediastinum. CECT of the chest demonstrated punctate foci of air and fat stranding along the anterior and superior mediastinum. Radiological evidence and the presence of necrosis on surgical debridement of the retropharyngeal abscess established the diagnosis of DNM. This case emphasizes the role of computed tomography (CT) in the diagnosis of DNM and demonstrates the utility of chest imaging in a high-risk patient who presents with a retropharyngeal abscess.

68-year-old male with descending necrotizing mediastinitis.

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Published

2023-08-15

Issue

Section

Thoracic Radiology