[Pneumomediastinum and mediastinitis, rare complications of a lung abscess. 1 case].

A case is reported with pneumomediastinum and mediastinitis complicating lung abscess in the lingula of a 77-year-old man. Causative factors were the association of virulent organisms having necrotizing properties in a host with diminished resistance and location of the cavity adjacent to the mediastinal pleura. A review of 1119 documented patients with lung abscess revealed that this complication has been reported only twice previously. Early surgical drainage combined with systemic administration of antimicrobial agents are the most effective therapeutic measures for mediastinal infection. Therefore, close observation is required of patients with lung abscess adjacent to mediastinal structures.