Abstract
A 12-month-old highly feverish boy showed progressive dyspnea with a necrotic adenopathy in the axillla upon an extensive anterior mediastinal abscess. The abscess was drained with a suprasternal incision and Staphylococcus aureus was identified. A subsequent antibiotic therapy with tazobactam and clindamycin was performed. In the following recovery was uneventful. In paediatric population aggressive treatment of mediastinal abscesses is needed to obtain full recovery. However, thoracotomy should be avoided in contrast to adults. We present a rare case of a huge non-traumatic mediastinal abscess in a 12-month-old boy. Literature of the last 15 years was reviewed and principals of paediatric surgical approach discussed.