case_images: PMC10597854_01
case_images: Initial CT scan image revealed abscess formation at left masticator space and palatine tonsil (yellow arrow), air-containing and fat stranding at middle and posterior mediastinum surrounding trachea, high suspected descending necrotizing mediastinitis(B), and bilateral basal lung atelectasis and empyema.
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case_images: Chest computed tomography revealed tonsil abscess, deep neck infection, and highly suspected descending necrotizing mediastinitis (Fig. 1).
case_images: During the course of infection control, the CRP plasma concentrations exhibited a rapid decline. At day 0, the maximum CRP concentration peaked at 467 mg/l. However, by day 28, the CRP levels had significantly decreased, reaching a minimum concentration of 19 mg/l.
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case_images: Fortunately, laboratory test revealed infection parameters improving (Fig. 2).
case_images: The repeated computed tomography scan was reported as below. Mild regression of residual abscess along left masseter muscle, submandibular region, palatine tonsil (yellow arrow), and mediastinum (A). Mild progressive bilateral lobulated complicated pleura effusion (yellow arrow) even adequate bilateral chest tube tips drainage function (B).
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case_images: Despite appropriate antibiotic treatment, a follow-up CT scan 2 weeks later still showed mild progression of abscess accumulation at neck, mediastinum and pleura space (Fig. 3).