PMC6202047_01
(A) Chest X-ray on arrival; (B) electrocardiogram on
arrival, indicating broad ST-elevation.
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A chest X-ray showed a slightly widened mediastinum with pleural effusion (Figure 1A). An ECG revealed widespread ST-elevation (Figure 1B).
(A) Coronal, (B) sagittal, and
(C-H) axial chest CT images on arrival.. Note: A large volume of gas had collected (arrowhead) with an abscess
(arrow) in the submandibular space, anterior neck space, and the upper and
anterior mediastinum.
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Contrast-enhanced CT images revealed that a large volume of gas had collected in the neck and upper and anterior mediastinum (Figure 2A-F). In addition, an abscess had formed in the retropharyngeal, bilateral sub-mandibular, upper paratracheal, and mediastinal spaces with pleural effusion and atelectasis in the right lower basal lobe (Figure 2B-H).
Pathological findings of excised skeletal muscle and fascia.. Notes: (A-C) Acute inflammation
with necrosis, consistent with necrotizing fasciitis; (D) Gram
staining revealed a large number of Gram-positive cocci.
tcrm-14-2013Fig3.jpg
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Pathological findings from the excised skeletal muscle and fascia indicated acute inflammation with necrosis (Figure 3A-C), consistent with necrotizing fasciitis, and a large number of Gram-positive cocci were observed (Figure 3D).