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Severe parapharyngeal abscess that developed significant complications: management during the COVID-19 pandemic
  1. Teslimat Ajeigbe1,
  2. Basmal Ria2,
  3. Emma Wates3 and
  4. Samuel Mattine1
  1. 1Oral and Maxillofacial Unit, Worcestershire Royal Hospital, Worcester, Worcestershire, UK
  2. 2Department of Oral Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  3. 3University Hospitals Bristol NHS Foundation Trust, Bristol, UK
  1. Correspondence to Dr Emma Wates; emma.wates{at}


A 50-year-old Caucasian man presented to the emergency department during the early stages of the COVID-19 pandemic with a rapidly progressive facial swelling, fever, malaise and myalgia. The patient had recently travelled to a COVID-19-prevalent European country and was therefore treated as COVID-19 suspect. The day before, the patient sustained a burn to his left forearm after falling unconscious next to a radiator. A CT neck and thorax showed a parapharyngeal abscess, which was surgically drained, and the patient was discharged following an intensive care admission. He then developed mediastinitis 3 weeks post-discharge which required readmission and transfer to a cardiothoracic unit for surgical drainage. This report discusses the evolution of a deep neck space infection into a mediastinitis, a rare and life-threatening complication, despite early surgical drainage. This report also highlights the difficulties faced with managing patients during the COVID-19 pandemic.

  • ear
  • nose and throat/otolaryngology
  • anaesthesia
  • cardiothoracic surgery
  • oral and maxillofacial surgery

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  • Contributors TA, BR, EW, SM: planning, conduct, reporting, conception and design, data acquisition and data interpretation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.