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Images in emergency medicine
Cervical necrotising fasciitis with descending mediastinitis
  1. Chih-Yang Hsiao,
  2. Abel Po-Hao Huang
  1. Department of Surgery, National Taiwan University Hospital, Taipei City, Taiwan
  1. Correspondence to Dr Abel Po-Hao Huang, Department of Surgery, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei City 100, Taiwan; how.how0622{at}gmail.com

https://doi.org/10.1136/emermed-2013-203313

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    An elderly woman presented with fever, sore throat, difficulty swallowing and substernal chest pain that radiated to her shoulder for 3 days. She was febrile (38.8°C), tachycardic (133 bpm), and hypotensive (85/54 mmHg). Physical exams revealed neck tenderness without lymphadenopathy and bulging of left pharyngeal wall. Laboratory exams revealed elevated both white blood cell count (19.25 K/μL) and C-reactive protein (16.19 mg/dL). Lateral X-ray …

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    Footnotes

    • Contributors CYH and APHH were responsible for the drafting of the manuscript. CYH conducted a survey and submitted the study.

    • Competing interests None.

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