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Fig. 4C. —53-year-old man with cervical necrotizing fasciitis and descending necrotizing mediastinitis. Initial cervical and thoracic CT scans show infection descending along parapharyngeal space from sublingual space (A). Carotid sheath and subclavian space are involved in infection (B), and cervical necrotizing fasciitis progresses to anterior mediastinum (C). Scans show bilateral pleural and pericardial effusion. Patient underwent percutaneous catheter drainage immediately.