Spontaneous Mediastinal Abscess in a Patient With Asthma Under Low Dose Steroid: A Case Report

Spontaneous mediastinal abscess with an occult source of infection is extremely rare and presents a diagnostic challenge. We report a unique case of a 60-year-old asthmatic patient who developed a spontaneous mediastinal abscess while receiving low-dose prednisolone (5 mg daily). Although such a dose is generally considered to have minimal immunosuppressive effects, the patient presented with severe systemic inflammation and a multiloculated abscess around the pericardium. The patient was successfully treated with a combination of surgical intervention and targeted antibiotics. This case highlights that even low-dose steroids can predispose patients to life-threatening spontaneous mediastinal infections, necessitating early recognition and aggressive management.