Successful treatment for a delay diagnosed esophageal perforation with deep neck infection,
mediastinitis, empyema, and sepsis.
Perforation of esophagus and subsequent
mediastinitis following mussel shell ingestion.
Sarcoidosis-associated fibrosing
mediastinitis with resultant pulmonary hypertension: a case report and review of the literature.
Previous studies reported that the most common bacteria identified in mediastinal abscess were of oropharyngeal origin, such as Klebsiella pneumoniae, Actinomyces , hemolytic Streptococcu s, and Streptococcus intermedius , suggesting that the translocation of oral and nasopharyngeal bacteria to deep mediastinal tissues through the transbronchial or transtracheal passage of the needle were the most possible causes of
mediastinitis or mediastinal abscess.[4] In addition, the infection may also be caused by bacteremia spread through the punctured wound.
Akin, "A case of fibrosing
mediastinitis with obstruction of superior vena cava and downhill esophageal varices: a rare cause of upper gastrointestinal hemorrhage," Journal of Clinical Gastroenterology, vol.
Pneumonia and empyema are the most common sources, but other potential sources include
mediastinitis, periodontal infection, subphrenic abscess, and sepsis [2].
In the only previously reported adult case, a patient who had undergone valve replacement surgery developed NTS bacteremia, aortic dissection, and
mediastinitis in the postoperative period; this patient had a stool culture that was positive for NTS [11].
Broad-spectrum antibiotics may also be prescribed to prevent development of life-threatening
mediastinitis. In severe cases with airways involvement, orotracheal intubation and tracheotomy are indicated.
Fibrosing
mediastinitis (FM) is a rare disorder characterized by the proliferation of locally invasive fibrous tissue within the mediastinum.
However, serious
mediastinitis due to cyst infection, malignant transformation [8], life threatening hematemesis or hemoptysis, and risk of bleeding from mucosal erosion [9] were reported.
[1,4] In addition, the manifestation of IgG4-RLD were mostly described as parenchymal nodules or masses, interstitial lung disease, mediastinal lymphadenopathy, and fibrosing
mediastinitis; [1,2,4,5] however, few studies reported cavitating IgG4-RLD.
En ocasiones, el diagnostico diferencial puede ser dificil, dada la presencia de sintomas similares entre las diferentes patologias, entre ellos [9, 18]: el sindrome de Boerhaave, que consiste en la ruptura de la pared esofagica posterior a episodios emeticos severos y se caracteriza por la presencia de dolor toracico severo; enfisema subcutaneo;
mediastinitis; fiebre e hipotension; sindrome coronario agudo; pericarditis; neumonia; neumotorax, y tromboembolismo pulmonar.