[Mediastinal abscess due to endotracheal intubation]

A 38-year-old woman was brought to hospital in an unconscious condition due to hypoglycemic coma. At 23 years of age she was diagnosed as having insulin-dependent diabetes mellitus. She had been treated with insulin but the control of her blood sugar was inadequate. Emergency endotracheal intubation was performed and she began to breathe spontaneously. Two days later, sore throat, swelling of the neck and fever appeared. She was therefore transferred to our hospital. CT showed a continuous abscess with multiple air bubble from the pharynx to the mediastinum. Cervical incision was performed and treatment with ampicillin, cefmetazole, and clyndamicin was started. Culture of the pus revealed alpha-streptococcus. The abscess decreased in size and her blood sugar was controlled by insulin and diet. She was discharged after 11 weeks of hospitalization. At that time CT showed only emphysematous change.