Abstract
A case of mediastinal abscess formed from deep neck infection is reported. A 59-year-old woman was first seen with chief complaints of right ear-ache and sore throat, and diagnosed as right otitis externa and pharyngitis. After that, the patient uregently admitted to the hospital, because hoarse voice, swelling in the right anterior cervix, and dyspnea appeared. The cervical swelling and dyspnea were further developed, and trachectomy was done on the first hospital day. Since her chest X-ray film revealed a clear and enlarged mediastinal shadow, CT exhibiting a possible shadow of mediastinal abscess, she was treated for drainage. The patient, however, was complicated by postoperative DIC and dead due to massive hematemesis and melena. An appearence of antibiotics with superior qualities is said to extremely decrease the development of deep neck infection, however, it can provide a delayed diagnosis and insufficient therapy which lead to severe complications. Mediastinal abscess in this case might be originated from parenchymatous tonsillitis through formation of lateral pharyngial abscess and postpharyngial abscess. We keenly realize a necessity of drainage with sufficient depth.
