Article Text

Download PDFPDF
Deep neck space infection extending to the mediastinum that was treated conservatively
  1. Haran Devakumar,
  2. Bhavesh Tailor,
  3. Sarah Law and
  4. Dimitrios Ioannidis
  1. ENT, Colchester General Hospital, Colchester, UK
  1. Correspondence to Dr Haran Devakumar; haran.devakumar{at}


Deep neck space infections (DNSIs) are challenging to diagnose and manage. A female ex-smoker presented with difficulty breathing and chest pain. She was initially treated for exacerbation of emphysema with intravenous antibiotics. The ear, nose and throat team were later asked to review the patient for left submandibular swelling and odynophagia. CT of the neck was performed 10 days later, due to limited availability during COVID-19. It showed an extensive retropharyngeal collection from the level of the vallecula to just above the carina. Normally, a DNSI extending to the mediastinum would require prompt surgical management. However, the patient was clinically well once imaged, so the abscess was managed conservatively with intravenous antibiotics.

  • COVID-19
  • Radiology
  • Head and neck surgery
  • Otolaryngology / ENT

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors HD wrote the original draft. BT edited and reviewed the manuscript. SL wrote the case presentation. DI edited and reviewed the manuscript.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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