Mediastinitis after whiplash injury

The authors describe a rare complication of whiplash injury. Diffuse mediastinitis resulted from extension of a whiplash-induced retropharyngeal abscess into the thorax. Early diagnosis of the cervical infection was masked by the simultaneous presence of infectious mononucleosis. Aggressive surgical management including bilateral thoracotomy was required to resolve the septic course. A review of the literature discusses the pathogenesis of this complication including the route of extension into the mediastinum and supports the use of aggressive surgical therapy to reduce the associated mortality.