CTICasesDescending necrotizing mediastinitis from cervical necrotizing fasciitis
Imaging findings
CT scan demonstrates extensive fluid and gas collections tracking from the neck soft tissues and sternocleidomastoid muscle down into the prevascular and middle mediastinum, with associated involvement of the sternoclavicular joint, representing descending necrotizing mediastinitis.
Key takeaways
Descending necrotizing mediastinitis is a highly lethal complication of deep neck infections (such as necrotizing fasciitis). Contrast-enhanced CT is essential for identifying the extent of the tracking gas and fluid and guiding surgical debridement.
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