Mediastinitis overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anthony Gallo, B.S. [2]

Overview

Mediastinitis is inflammation or infection of the tissues in the mid-chest, or mediastinum.[1] This disorder is rare, but is most often observed among patients following chest surgery or endoscopy. Mediastinitis may occur at any age.[2] It may be classified according to cause into 2 groups: acute or chronic (fibrosing). Acute mediastinitis is usually bacterial and due to rupture of organs in the mediastinum. Chronic sclerosing (or fibrosing) mediastinitis, while potentially serious, is caused by a long-standing inflammation of the mediastinum, leading to growth of acellular collagen and fibrous tissue within the chest and around the central vessels and airways. Life threatening causes of mediastinitis include esophageal perforation. Common causes of mediastinitis trauma, beta-hemolytic streptococcus, forceful or constant vomiting and median sternotomy. If left untreated, fibrosing mediastinitis may progress into sepsis and subsequently, death. The presence of mediastinitis among patients following chest surgery is observed to have a particularly poor prognosis; there is a serious risk of death.[3] Common complications of mediastinitis include sepsis and spread of the infection. Symptoms of mediastinitis include chest pain, malaise, and shortness of breath[4]


References

  1. Koksal D, Bayiz H, Mutluay N, Koyuncu A, Demirag F, Dagli G; et al. (2013). "Fibrosing mediastinitis mimicking bronchogenic carcinoma". J Thorac Dis. 5 (1): E5–7. doi:10.3978/j.issn.2072-1439.2012.07.03. PMC 3548007. PMID 23372962.
  2. Abboud CS, Wey SB, Baltar VT (2004). "Risk factors for mediastinitis after cardiac surgery". Ann Thorac Surg. 77 (2): 676–83. doi:10.1016/S0003-4975(03)01523-6. PMID 14759458.
  3. Mediastinitis: a potentially lethal infection. Thoracics (2012). http://thoracics.org/2012/03/03/mediastinitis-noncardiac-surgery/ Accessed on September 25, 2015.
  4. Lewandowski B, Pakla P, Wołek W, Jednakiewicz M, Nicpoń J (2014). "A fatal case of descending necrotizing mediastinitis as a complication of odontogenic infection. A case report". Kardiochir Torakochirurgia Pol. 11 (3): 324–8. doi:10.5114/kitp.2014.45685. PMC 4283893. PMID 26336443.


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