In each case, treatment should be individualized to the clinical presentation and suspected cause. [ncbi.nlm.nih.gov]

CLINICAL PRESENTATION The most common presenting symptom is chest pain (85% of cases). 12 The pain can in the interscapular upper back area given the proximity of the esophagus to the spine. [journals.lww.com]

In the present report we describes three cases of cervical necrotizing fasciitis complicated by acute mediastinitis. All patients were apparently immunocompetent adults. [roderic.uv.es]

• Fever

  A 24-year-old woman was admitted to our hospital for complaints of chest pain and fever and was subsequently diagnosed as having an anterior mediastinal tumor. [ncbi.nlm.nih.gov]

  Fevers with tachycardia and elevation of inflammatory markers usually indicate an infectious etiology that should be worked up. [journals.lww.com]

  Early signs and symptoms include fever, severe pain and swelling, and redness at the wound site. Moreover, fulminant evolution and high mortality rate are typical of this pathology. [roderic.uv.es]

  We have described a case of acute necrotising mediastinitis in a young woman who was referred to our attention owing to a swelling in the oral floor, fever, trismus and pharyngodynia that had appeared about 10 days earlier after a tooth abscess that did [minervamedica.it]

  Acute mediastinitis is often associated with chills, fever, or shock. If pleural extension develops, breathing may aggravate the pain or cause radiation to the shoulder. Swallowing increases the pain, and dysphagia may be present. [for-surgeons.com]

• Painful Cough

  Most of the pancreaticopleural fistula patients are admitted to the hospital with respiratory symptoms since common complaints include dyspnea, chest pain, cough, sputum and fever[ 7 ]. [wjgnet.com]

• Mediastinal Disease

  Mid or Lower Retrosternal Pain in mediastinal disease Character resembling cardiac pain, radiate to neck and arms, unrelated to exertion. [notes.medicosnotes.com]

• Dysphagia

  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. [medical-dictionary.thefreedictionary.com]

  Swallowing increases the pain, and dysphagia may be present. The patient is febrile, and tachycardia is noted. About 60% of patients with acute mediastinitis have subcutaneous emphysema or pneumomediastinum. [for-surgeons.com]

  Typical Presentation The most common presentation is acute onset of fever, chest pain, dysphagia and respiratory distress. Dysphagia is characteristic of esophageal perforation. [emdocs.net]

  The chief complains were a very painful dysphagia, impaired general condition with fever. [panafrican-med-journal.com]

  Development of a localized mediastinal abscess can also result in findings related to mass effect, which can lead to dysphagia or dyspnea from deviation or compression of the trachea or esophagus, respectively, hoarseness from compression of the recurrent [cancertherapyadvisor.com]

• Odynophagia

  Severe odynophagia and respiratory distress with positive neck or chest findings should raise suspicion of mediastinitis. We report a rare case of acute mediastinitis secondary to the unexpected migration of an impacted fish bone from the esophagus. [ncbi.nlm.nih.gov]

  Patients may also present with odynophagia, dyspnea, tachypnea, cyanosis, tachycardia, fever, and hypotension which may develop within hours of the perforation. [journals.lww.com]

• Chest Pain

  A 24-year-old woman was admitted to our hospital for complaints of chest pain and fever and was subsequently diagnosed as having an anterior mediastinal tumor. [ncbi.nlm.nih.gov]

  Without ignoring possible cardiac or pulmonary etiologies, it is important to remember that any structure in the chest can result in “chest pain.” Esophageal etiologies of chest pain are commonly ignored. [journals.lww.com]

  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. [medical-dictionary.thefreedictionary.com]

  Other common complaints were chest pain and cough in 30% and 22% of patients, respectively[ 16 ]. [wjgnet.com]

• Retrosternal Chest Pain

  Retrosternal chest pain causes are given below Ischaemic heart disease. Oesophagitis or diffuse oesophageal spasm. Acute dry percardltis. Acute mediastinitis. Diaphragmatic hernia. Aneurysm of the aorta. Dissecting aneurysm. Psychogenic. [notes.medicosnotes.com]

  Patients present with severe retrosternal chest pain that may increase with swallowing or deep breathing. Patients frequently have subcutaneous and mediastinal emphysema. [aafp.org]

In such a situation the patients should be qualified earlier for broadened diagnostic workup and for reoperation. [ncbi.nlm.nih.gov]

Laboratory workup revealed leukocytosis of 14,640/μL with a predominance of neutrophils (82.4%). Electrocardiogram, chest radiograph, and serum Troponin T were normal. [journals.lww.com]

Laboratory workup is shown in Table 1. Table 2. Body fluid analysis Initial radiographic imaging (chest x-ray) showed widening of the superior mediastinum, bilateral effusions and prominent aortic arch ( Figure 1 ). [pubs.sciepub.com]

• Mycoplasma Hominis

  Sielaff TD, Everett JE, Shumway SJ, Wahoff DC, Bolman RM, III, Dunn DL (1996) Mycoplasma hominis infections occurring in cardiovascular surgical patients. Ann Thoracic Surg 61:99–103 Google Scholar 84. [link.springer.com]

• Streptococcus Pneumoniae

  Maroto LC, Aguado JM, Carrascal Y, Rodriguez JE, Cortina JM, Rufilanchas JJ (1996) Fulminant mediastinitis due to Streptococcus pneumoniae following cardiac surgery: report of a case. Clin Infect Dis 22:594–595 PubMed Google Scholar 77. [link.springer.com]

CONCLUSIONS: Delay in initiating treatment and intrathoracic esophageal foreign bodies are the main risk factors of mediastinitis secondary to foreign body ingestion. Computed tomography plays an important role in diagnosis and guiding treatments. [ncbi.nlm.nih.gov]

[…] in reaching a full diagnosis and treatment. 10 Diagnosing acute mediastinitis through conventional x-rays alone may delay treatment, and if mediastinitis is suspected based on clinical signs, computed axial tomography should be performed. [archbronconeumol.org]

To include and estadarize the hiperbaric oxygen therapy like a part of the protocol for the treatment in patients with mediastinitis. [new.medigraphic.com]

This study was a retrospective evaluation of selected biochemical parameters with negative impact on the prognosis in surgically treated patients. [ncbi.nlm.nih.gov]

The total score enables to predict the prognosis [ 25 ]. [wjes.biomedcentral.com]

[…] ascending aorta pulmonary trunk nerves cardiac plexus phrenic nerves other structures heart anterior mediastinum contains no major structures posterior mediastinum vessels descending aorta azygous venous system other structures esophagus thoracic duct Prognosis [medbullets.com]

The occurrence of these complications darkens the prognosis of this affection usually benign. [panafrican-med-journal.com]

MATERIAL/METHODS: There were 44 consecutive patients treated surgically due to AM of differentiated etiology. [ncbi.nlm.nih.gov]

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 [medical-dictionary.thefreedictionary.com]

Without ignoring possible cardiac or pulmonary etiologies, it is important to remember that any structure in the chest can result in “chest pain.” Esophageal etiologies of chest pain are commonly ignored. [journals.lww.com]

Non-infectious etiologies, such as cardiac ischemia/arrhythmia or pneumothorax/pneumomediastinum can also present similarly. [cancertherapyadvisor.com]

The etiology of AM does not remain insignificant. [wjes.biomedcentral.com]

Neurology and Neurosurgery Czech and Slovak Ophthalmology Czech and Slovak Psychiatry Czech Geriatric Review Czech Gynaecology Czech Rheumatology Czech Dental Journal Czech Urology Czech-Slovak Dermatology Czecho-Slovak Pathology Czech-Slovak Pediatrics Epidemiology [prolekare.cz]

granulomatous disease) Epidemiology incidence 3% incidence of acute mediastinitis following sternotomy very low incidence of chronic mediastinitis risk factors recent sternotomy Pathophysiology mechanism of injury acute contamination from esophageal [medbullets.com]

Shafazand S, Doyle R, Ruoss S, Weinacker A, Raffin TA (1999) Inhalational anthrax: epidemiology, diagnosis, and management. Chest 116(5):1369–1376 PubMed Google Scholar 126. [link.springer.com]

Epidemiology Approximately 60,000 patients develop pleural infections in the United States each year. Between 40-60% of pneumonias will be associated with parapneumonic effusions. [clinicaladvisor.com]

[…] associated with Histoplasma capsulatum and Mycobacterium tuberculosis, though mediastinitis is an extremely rare complication of these infections. [16] Acute mediastinitis has also been reported as a complication of Epstein-Barr virus infection. [20] Epidemiology [emedicine.medscape.com]

To discuss the pathophysiology of this disease, the authors reported the details of esophageal perforations experienced in our institute and reviewed the literature. [jstage.jst.go.jp]

We postulated that the pathophysiology of this mediastinitis was similar to pleural and peritoneal fistula. [wjgnet.com]

granulomatous disease) Epidemiology incidence 3% incidence of acute mediastinitis following sternotomy very low incidence of chronic mediastinitis risk factors recent sternotomy Pathophysiology mechanism of injury acute contamination from esophageal [medbullets.com]

Pathophysiology Empyema The potential space between the parietal pleura and visceral pleura normally contains small amounts of circulating, sterile fluid that can become infected by an adjacent pneumonia or bronchopleural fistula, or seeded by bacteremia [clinicaladvisor.com]

[…] nodes, the phrenic nerves, the great vessels, and the trachea Posterior - The physiology of the posterior mediastinum includes the azygos vein, the descending aorta, the esophagus, the lymph nodes, the thoracic duct, and the vagus and sympathetic nerves Pathophysiology [emedicine.medscape.com]

Early diagnosis with prompt and aggressive treatment is essential to prevent its rapid progression. Severe odynophagia and respiratory distress with positive neck or chest findings should raise suspicion of mediastinitis. [ncbi.nlm.nih.gov]

Intravenous antibiotics are a crucial part of this treatment to help prevent / and treat possible sepsis. [thoracics.org]

Centers for Disease Control and Prevention (1999) Bioterrorism alleging use of anthrax and interim guidelines for management — United States, 1998. MMWR Morb Mortal Wkly Rep 48:69–74 Google Scholar 121. [link.springer.com]

This approach can prevent the need for a sternotomy or thoracotomy in spite of concomitant pulmonary involvement. Emergency physicians need to be familiar with this rare but lethal disease. [mrmjournal.biomedcentral.com]

Jarvis Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee Am J Infect Control, 27 (1999), pp. 97-132 [7.] D. Lepelletier, S. Perron, P. [archbronconeumol.org]