Nontraumatic suppurative mediastinitis presenting as acute mediastinal widening.

A case of acute nontraumatic suppurative mediastinitis in a 56-year-old man is presented. The patient was admitted with signs and symptoms of a left lower lobe pneumonia and acutely developed mediastinal widening on chest radiograph. A mediastinal abscess was drained by posterior mediastinotomy after a complicated hospital course. Mediastinitis is a rare complication of pneumonia. It is a serious condition, requiring prompt diagnosis and aggressive therapy, and should be considered in the differential diagnosis of acute mediastinal widening.