A case of descending necrotizing mediastinitis and Lemierre’s syndrome associated with an odontogenic infection

Introduction: Descending necrotizing mediastinitis is a rare complication of odontogenic infections, with a high mortality rate despite the advent of antibiotics. case report: An otherwise well 37-year-old male presented with descending necrotizing mediastinitis secondary to a mandibular second molar infection. He required prolonged targeted antibiotic treatment, extensive oral, neck and thoracic surgery. After a 68-day intensive care unit admission he was stepped-down to the ward for further monitoring. this admission was complicated septic shock, Lemierre’s syndrome and a right phrenic nerve injury. conclusion: Odontogenic infections are common presentations to the local dentist yet many patients delay definitive management, placing them at increased risk of severe complications. this clinical case highlights the multiple potentially fatal complications (including Lemierre’s syndrome) associated with descending necrotizing mediastinitis originating from an infected mandibular second molar.