ABSTRACT
We report a case in which granulomatous mediastinitis caused by histoplasmosis led to life-threatening esophageal-mediastinal fistula with secondary streptococcal mediastinal abscess, purulent pericarditis, and cardiac tamponade. We describe the esophago-bronchial double-transillumination maneuver that can be used to safely drain mediastinal abscesses when the anatomy is distorted.
