• Taha G Elsahy, Hadil A Alotair, Abdulaziz H Alzeer, and Sami A Al-Nassar.
• Department of Critical Care, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail. hadil.alotair@live.com.
• Saudi Med J. 2014 Sep 1; 35 (9): 1123-6.

AbstractDescending necrotizing mediastinitis (DNM) is a rare but severe life threatening complication of oropharyngeal infections. We report a young lady who had severe pharyngitis complicated by anterior neck infection that descended to the mediastinum causing necrotizing mediastinitis. The course of her illness was complicated with septic shock, acute kidney injury, tracheo-esophageal fistula, and critical illness polyneuropathy. There was considerable delay in her diagnosis; however, she survived after aggressive surgical intervention, wide spectrum antibiotics, and appropriate intensive care management. Early and repeated chest imaging using computed tomography was vital for the detection and follow up of this case. There is a need to increase physicians' awareness of this condition that can complicate odontogentic or pharyngeal infection, procedures, or trauma.

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