Mediastinitis

Inflammatory process affecting the mediastinum

Mediastinitis
Mediastinum.jpg
Mediastinum

An inflammatory process affecting the mediastinum.

Types

Mediastinitis can be acute or chronic, depending on the onset.

Risk factors

It most often occurs in person who recently had an upper endoscopy or chest surgery.

• A person may have a tear in their esophagus that causes mediastinitis.
• Disease of the esophagus
• Diabetes mellitus
• Problems in the upper gastrointestinal tract
• Recent chest surgery or endoscopy
• Weakened immune system

Causes

Causes of the tear include:

• A procedure such as endoscopy
• Forceful or constant vomiting
• Trauma
• A fungal infection called histoplasmosis
• Radiation
• Inflammation of the lymph nodes, lungs, liver, eyes, skin, or other tissues (sarcoidosis)
• Tuberculosis
• Breathing in anthrax
• Cancer

Signs and symptoms

• Chest pain
• Chills
• Fever
• General discomfort
• Shortness of breath

Signs of mediastinitis in people who have had recent surgery include:

• Chest wall tenderness
• Wound drainage
• Unstable chest wall

Investigations

Tests may include:

• Chest CT scan or MRI scan
• Chest x-ray
• Ultrasound
• MRI of the chest

Treatment

You may receive antibiotics if you have an infection.

You may need surgery to remove the area of inflammation if the blood vessels, windpipe, or esophagus is blocked.

Prognosis

• How well a person does depends on the cause and severity of the mediastinitis.
• Mediastinitis after chest surgery is very serious. There is a risk of dying from the condition.

Complications

Complications include the following:

• Spread of the infection to the bloodstream, blood vessels, bones, heart, or lungs
• Scarring - Scarring can be severe, especially when it is caused by chronic mediastinitis. Scarring can interfere with heart or lung function.

Prevention

• To lessen the risk of developing mediastinitis related to chest surgery, surgical wounds should be kept clean and dry after surgery.
• Treating tuberculosis, sarcoidosis, or other conditions associated with mediastinitis may prevent this complication.

Alternative Names: Chest infection

External links

• Mediastinitis at the US National Library of Medicine Medical Subject Headings (MeSH)

• Mediastinum
  Mediastinum
• 
  Mediastinum
• CT scan of a patient with Descending Necrotizing Mediastinitis
  CT scan of a patient with Descending Necrotizing Mediastinitis