CTICasesDescending necrotizing mediastinitis
Imaging findings
Neck and chest CT show severe deep neck abscesses and multi-compartment mediastinal fluid/gas collections extending below the carina, associated with marked tracheal deviation. Cultures grew Streptococcus milleri as part of a polymicrobial periodontal infection.
Key takeaways
Descending necrotizing mediastinitis is a highly lethal, rapidly progressive infection originating from deep neck or odontogenic/periodontal infections. Streptococcus milleri is a common pathogen, and prompt surgical debridement and drainage are essential to decrease high mortality rates.
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