[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-135729-105":59,"doc-detail-135729-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","wisdom-tooths-revenge-retropharyngeal-abscess-and-mediastinitis-after-molar-tooth-extraction","Wisdom Tooth's Revenge: Retropharyngeal Abscess and Mediastinitis after Molar Tooth Extraction","","Retropharyngeal abscess can cause severe morbidity and mortality due to direct anatomical continuity with the mediastinum. This case report reviews clinically important deep-neck anatomy and the infection spread patterns from deep neck space infection progressing to mediastinitis and empyema. An otherwise healthy adult developed progressive symptoms after third molar extraction despite initial oral antibiotics, with imaging demonstrating contiguous spread to the mediastinum and pleural space.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/wisdom-tooths-revenge-retropharyngeal-abscess-and-mediastinitis-after-molar-tooth-extraction/135729/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/wisdom-tooths-revenge-retropharyngeal-abscess-and-mediastinitis-after-molar-tooth-extraction/135729.png","ImageObject",300,407,{"name":92,"@type":93},"Riley West","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-22","2026-08-21",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is retropharyngeal abscess considered high risk?","Question",{"text":112,"@type":113},"Because it can spread directly to the mediastinum through anatomical connections, leading to potentially severe morbidity and mortality.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What triggered the patient’s deep neck infection in this case?",{"text":117,"@type":113},"Symptoms developed after an otherwise uncomplicated removal of all four third molar teeth, occurring about three weeks post-procedure.",{"name":119,"@type":110,"acceptedAnswer":120},"How was the spread to the mediastinum and pleural space evaluated and treated?",{"text":121,"@type":113},"Repeat contrast-enhanced CT of the neck and an additional chest CT confirmed multiple deep neck abscesses and large loculated mediastinal and pleural collections; urgent thoracotomy with drainage, decortication, broad-spectrum antibiotics, and wound therapy were performed.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},135729,1787318985,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":46},1099523885074,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Journal of Radiology Case Reports  \nWisdom Tooth's Revenge: Retropharyngeal Abscess and Mediastinitis after Molar Tooth Extraction  \nF Eymen Ucisik-Keser1, Eliana E Bonfante-Mejia1, Daniel Ocazionez-Trujillo1, Steven S Chua 1*  \n1. Diagnostic and Interventional Radiology, UT Health Science Center McGovern Medical School, Houston, TX, USA  \n* Correspondence: F Eymen Ucisik-Keser, Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street MSB 2. 130B, Houston, TX 77030, USA  \n( [Fehime.E. UcisikKeser@uth.tmc.edu](Fehime.E. UcisikKeser@uth.tmc.edu))  \nRadiology Case. 2019 Feb; 13(2):1-8 :: DOI: 10.3941/jrcr.v13i2 .3452  \nABSTRACT  \nRetropharyngeal abscess is potentially associated with high morbidity and  \nmortality as a result of its direct anatomical connection with the  \nmediastinum. Therefore, knowledge of the relevant anatomy is essential for  \nrecognizing the presence and extent of disease in a timely manner. In this  \ncase report, we aim to review the pertinent anatomy and patterns of spread of  \ninfection from a full blown deep neck space infection to result in  \nmediastinitis and empyema.  \nCASE REPORT  \nCASE REPORT  \nAn otherwise healthy 24 year old female who had undergone an uncomplicated removal of all four third molar teeth 3 weeks earlier, presented to the emergency room with increasing throat pain. The patient reported \"spitting pus\" that was “dripping down her throat”, cough, pain on inspiration and“feeling feverish”. In the interim, she had been treated with oral antibiotics due to fever and throat pain, with no relief of symptoms. Physical examination revealed right sided neck swelling and decreased breath sounds on the left. She was found to be septic, with a low-grade fever of 37.8 degrees Celsius and leukocytosis with total leukocyte count of 14000 cells/ml3 of blood (normal range: 4500-11000) . Review of her outside facility contrast enhanced computerized tomography (CT) of the neck from 2 weeks prior to her emergency room visit showed rim enhancing interconnected fluid collections within the deep spaces of the neck, including the retropharyngeal, mucosal pharyngeal, prevertebral, and bilateral carotid spaces (Figure 1), with these fluid collections extending inferiorly towards the mediastinum. A repeat contrast enhanced neck CT and an additional chest CT were performed in the emergency room. The neck CTredemonstrated multiple deep neck space abscesses. Chest CT  \nrevealed large loculated collections in the mediastinum and left pleural space (Figure 2) .  \nShe was taken to the operating room for urgent thoracotomy and partial decortication of the left lung, with drainage of 750 ml of purulent material. A French Blake drain was placed into the mediastinum and two chest tubes wereplaced into the left pleural space. A Wound VAC (Vacuum Assisted Closure Device; KCI International, San Antonio, TX) was placed into the chest incision. This was followed by incision and drainage of the deep neck space abscesses, with placement of two Penrose drains in the superior and inferior abscess cavities. The neck incision was left partially open and was packed with absorbent dressings. A week later, reexploration of the chest and further partial decortication of the left lung was performed due to increased drainage from the chest tube and worsening leukocytosis.  \nHIV test and immunoglobulin panel were negative for immunosuppression. Abscess cultures grew mixed oral flora organisms including alpha Streptococcus, Enterobacter, anaerobe gram-negative bacilli and yeast.  \nMeanwhile, the patient complained of persistent “water dripping down her throat” during daily irrigations through her  \n[www.RadiologyCases.com](www.RadiologyCases.com)  \nJournal of Radiology Case Reports  \nneck incision. Fluoroscopic examination of the neck with oral water soluble contrast revealed passage of the contrast from the oropharynx into the enlarged and ai","cbCaiaE4H7r9rA7Z","https://ap.wps.com/l/cbCaiaE4H7r9rA7Z","pdf",609584,"English","# Abstract\n# Case Report\n## Clinical Presentation\n## Imaging and Diagnosis\n## Surgical and Medical Management\n## Follow-up and Outcome\n# Discussion\n## Etiology & Demographics","[{\"question\":\"Why is retropharyngeal abscess considered high risk?\",\"answer\":\"Because it can spread directly to the mediastinum through anatomical connections, leading to potentially severe morbidity and mortality.\"},{\"question\":\"What triggered the patient’s deep neck infection in this case?\",\"answer\":\"Symptoms developed after an otherwise uncomplicated removal of all four third molar teeth, occurring about three weeks post-procedure.\"},{\"question\":\"How was the spread to the mediastinum and pleural space evaluated and treated?\",\"answer\":\"Repeat contrast-enhanced CT of the neck and an additional chest CT confirmed multiple deep neck abscesses and large loculated mediastinal and pleural collections; urgent thoracotomy with drainage, decortication, broad-spectrum antibiotics, and wound therapy were performed.\"}]","Wisdom Tooth's Revenge: Retropharyngeal Abscess and Mediastinitis after Molar Tooth Extraction | PDF"]