A case of deep neck infection that took a turbulent course and resulted in death was reported. The patient was a 65-year old male. Initial symptoms were swelling and pain of the throat, and high fever. On admission, swelling of the inferior portion of the right mandibular angle was observed. Leukocytosis was present but general condition was good. On cervical and chest X-ray, abnormal shadow was not observed but the distance between vertebrae and trachea was markedly wide. A parapharyngeal abscess was suspected and antibiotics were given. The patient complained of dyspnea 20 hours after admission. Emergency tracheotomy was done but the condition did not improved. Emergency drainage operation revealed necrosis of the carotid seath and cervical esophagus. The patient died two days after admission because of renal failure probably caused by septic shock. At autopsy, inflammation spread into the posterior mediastinum via danger space. It was one of the reason that this case took a turbulent course. Emergency drainage operation should be done in cases of deep neck infection where the distance between vertebrae and trachea is markedly wide.
