Retropharyngeal abscess with mediastinal extension
Fever, chest pain.
CT neck and upper chest
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There is air tracking in the neck along the left retropharyngeal space and left anterior cervical spaces continues at the superior and middle mediastinum till infracarina region encircling the trachea and esophagus forming dependent air fluid levels and showing marginal enhancement.
This case demonstrates retropharyngeal abscess with inferior extension into the mediastinum resulting in mediastinitis with abscess formation.
It is considered a surgical emergency with high mortality rate. It can be primarily from structures in the mediastinum (often as a result of iatrogenic injury) or may result from an infection extending downward from the oropharynx, in which case it is called descending necrotizing mediastinitis (DNM).