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The day before, the patient sustained a burn to his left forearm after falling unconscious next to a radiator. A CT neck and thorax showed a parapharyngeal abscess, which was surgically drained, and the patient was discharged following an intensive care admission. He then developed mediastinitis 3\u2009weeks post-discharge which required readmission and transfer to a cardiothoracic unit for surgical drainage. This report discusses the evolution of a deep neck space infection into a mediastinitis, a rare and life-threatening complication, despite early surgical drainage. This report also highlights the difficulties faced with managing patients during the COVID-19 pandemic.<\/jats:p>","DOI":"10.1136\/bcr-2020-236449","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T18:18:21Z","timestamp":1608661101000},"page":"e236449","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Severe parapharyngeal abscess that developed significant complications: management during the COVID-19 pandemic"],"prefix":"10.1136","volume":"13","author":[{"given":"Teslimat","family":"Ajeigbe","sequence":"first","affiliation":[{"name":"Oral and Maxillofacial Unit, Worcestershire Royal Hospital, Worcester, Worcestershire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basmal","family":"Ria","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Wates","sequence":"additional","affiliation":[{"name":"University Hospitals Bristol NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Mattine","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Unit, Worcestershire Royal Hospital, Worcester, Worcestershire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"key":"2025082802483633000_13.12.e236449.1","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/j.otohns.2006.07.007","article-title":"Head and neck space infections","volume":"135","author":"Larawin","year":"2006","journal-title":"Otolaryngology\u2013Head and Neck Surgery"},{"key":"2025082802483633000_13.12.e236449.2","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s00405-004-0800-6","article-title":"Complications and management in adults","volume":"262","author":"Alaani","year":"2005","journal-title":"European Archives of Oto-Rhino-Laryngology and Head & Neck"},{"key":"2025082802483633000_13.12.e236449.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2010.05.030"},{"key":"2025082802483633000_13.12.e236449.4","unstructured":"Worldometers . 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