mediastinitis


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Related to mediastinitis: Fibrosing Mediastinitis

mediastinitis

 [me″de-as″tĭ-ni´tis]
inflammation of the mediastinum.
fibrosing mediastinitis (fibrous mediastinitis) mediastinal fibrosis.

me·di·as·ti·ni·tis

(mē'dē-as'ti-nī'tis),
Inflammation of the cellular tissue of the mediastinum.

mediastinitis

Inflammation of the mediastinum.

Acute mediastinitis
A fulminant infectious process with a high morbidity and mortality, in which organisms rapidly spread through areolar planes of mediastinum.
 
Aetiology
Traumatic oesophageal perforation, foreign bodies, suture line leakage, post-emetic rupture.
 
Clinical
Chest pain, dysphagia, respiratory distress, cervical-upper thoracic subcutaneous crepitus.
 
Imaging
By chest X-ray (CXR); may be normal early, followed by evidence of mediastinal and subcutaneous air.
 
Management
Aggressive and early with antibiotics; fluid resuscitation; chest tubes for pneumothorax or effusions; thoracotomy and surgical repair.
 
Chronic mediastinitis
A relatively indolent process characterised by chronic (“round cell”) inflammation and fibrosis.
 
Aetiology
Most often the result of a granulomatous process (e.g., TB, histoplasmosis) but may be idiopathic, as in sclerosing mediastinitis.
 
Clinical
Often silent if no oesophageal obstruction occurs.
 
Imaging
CXR; may be normal or mediastinum widened.
 
Management
Thoracotomy to confirm diagnosis or relieve obstruction.

mediastinitis

Surgery Inflammation of the mediastinum. See Mediastinoscopy, Mediastinum.
Mediastinitis
Acute mediastinitis A fulminant infectious process with a high M&M, in which organisms rapidly spread through areolar planes of mediastinum Etiology Traumatic esophageal perforation, foreign bodies, suture line leakage, post-emetic rupture Clinical Chest pain, dysphagia, respiratory distress, cervical-upper thoracic subcutaneous crepitus CXR May be normal early, followed by evidence of mediastinal and subcutaneous air Management Aggressive and early with antibiotics, fluid resuscitation, chest tubes for pneumothorax or effusions, thoracotomy and surgical repair
Chronic mediastinitis A relatively indolent process characterized by chronic–'round cell' inflammation and fibrosis Etiology Most often the result of a granulomatous process, eg TB, histoplasmosis, but may be idiopathic, as in sclerosing mediastinitis Clinical Often silent if no esophageal obstruction occurs CXR May be normal or mediastinum widened Management Thoracotomy to confirm diagnosis or relieve obstruction  

me·di·as·ti·ni·tis

(mē'dē-as'ti-nī'tis)
Inflammation of the cellular tissue of the mediastinum.

mediastinitis

Inflammation of the MEDIASTINUM.

me·di·as·ti·ni·tis

(mē'dē-as'ti-nī'tis)
Inflammation of the cellular tissue of the mediastinum.
References in periodicals archive ?
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.