Acute mediastinitis is a serious infection of the mediastinal connective tissues and the structures which they surround. One of the most lethal forms of mediastinitis is descending necrotizing mediastinitis (DNM), which usually occurs as a complication of odontogenic infections or peritonsillar abscesses.1,2 Most oropharyngeal infections are self-limiting and contained. However, they can spread through the fascial and deep neck spaces while progressing inferiorly into the mediastinum, especially in the diabetic, immunocompromised, or debilitated patient