ABSTRACT
Modern antibiotic therapy and rapid surgical intervention have greately reduced the complication from the spread of odontogenic infections. Nevertheless, fatalities from dental infections continue to occur. One of the most threaded, and probably lethal form is the mediastinal abscess. This is a case of Ludwig's angina dissected along deep cervical planes into the mediastinum caused a virulent mediastinitis and abscess, computed tomography precisely delineated the extent of the infection. Incomplete debridement resulted in a residual abscess and persistent systemic sepsis that culminated in the patient's death. Aggressive antibiotic treatment of the orofacial cellulitis along with complete mediastinal drainage are recommended for optimal outcome.