Gas forming Necrotizing Retropharyngeal and Parapharyngeal Abscess with Mediastinal Extension Causing Supraventricular Tachycardia.

M. PAUL¹, A. NAJIHAH¹, K. ESHAMSOL¹, Irfan MOHAMAD²

¹Department of Otorhinolaryngology of Hospital Sultan Haji Ahmad Shah, 28000, Temerloh, Pahang, Malaysia.

²Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kota Bharu, Kelantan, Malaysia.

ABSTRACT      

Combination of gas forming necrotizing retropharyngeal and parapharyngeal abscesses with mediastinal extension are rare, especially if the condition is complicated by development of chest pain and supraventricular tachycardia due to mediastinitis. We reported a case of a diabetic elderly man with previously known hypertension who was initially treated in a peripheral hospital with neck cellulitis which was complicated by chest pain, dyspnea and supraventricular tachycardia. He recovered fully after a series of neck surgeries and prolonged course of intravenous meropenem which was later changed to amikacin based on sensitivity over a period of 2 months.

Keywords: Necrotizing Retropharyngeal abscess, mediastinum, mediastinitis, Supraventicular tachycardia.

Correspondence author: Dr. Mark Paul,

Department of Otorhinolaryngology of Hospital Sultan Haji Ahmad Shah, 28000, Temerloh, Pahang, Malaysia.

Email: markpaul3288@gmail.com

Brunei Int Med J. 2017; 13 (5): 169-172