Retropharyngeal abscess with mediastinitis

Case contributed by Dr Ian Bickle

Presentation

Middle aged diabetic patient with fever and left sided neck swelling.

Patient Data

Age: 60 years
Gender: Male

Left submandibular space collection extending posteriorly via the left parapharyngeal space around the pharynx into the retropharyngeal space.

The collection further involves the pre-vertebral space with extension nto the superior mediastinum.

Case Discussion

Infections of the head and neck can be life threatening, especially when involving the retropharyngeal, pre-vertebral and danger spaces and tracking into the mediastinum, causing a mediastinitis.

The vast majority of patient's are immunosupressed, in particular have diabetes mellitus.

Knowledge of the anatomical spaces of the neck and neck is invaluable.

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