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A 46-year-old woman presents to the emergency department for evaluation of fever, dysphagia, chest pain, and difficulty breathing which developed over the last 36 hours. Two days ago, she underwent endoscopic evaluation for medication-resistant gastroesophageal reflux disease. Vital signs are significant for a temperature of 102° F (38.9° C). Physical examination reveals a midline fluctuance in the posterior oropharynx concerning for abscess. Computed tomography of the neck and chest confirms the presence of abscess and evidence of superior mediastinitis.

Which of the following structures of the deep neck is most likely responsible for conveying infection from this patient’s abscess to the mediastinum?

  • A) Alar fascia
  • B) Pharyngeal mucosa
  • C) Prevertebral fascia
  • D) Prevertebral space
  • E) Retropharyngeal space


Alexandra Conway


Dr. Ted O'Connell

Last updated

Jan 22, 2024

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