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Mediastinal Abscess


Presentation

  • To our knowledge, no other such case has ever been reported and we present this unusual case herein, followed by a short review of the related literature.[ncbi.nlm.nih.gov]
Patient Appears Chronically Ill
  • These patients appear chronically ill and have fevers generally below 39 C. Uncommon but suggestive findings include amphoric breath sounds over the abscess cavity and clubbing of the fingers.[pulmonologyadvisor.com]
Fever of Unknown Origin
  • Measures should be taken to reduce the risk and staphylococcal infection should not be forgotten in any dialysis patient with fever of unknown origin.[ncbi.nlm.nih.gov]
Recurrent Infection
  • Three days after the initial débridement and vacuum-assisted closure treatment, successful reconstruction was performed using an intercostal muscle flap and primary sternal closure, without recurrent infection.[ncbi.nlm.nih.gov]
Constitutional Symptom
  • CT-guided percutaneous aspiration of abscess was done with immediate relief in compressive but persistence of constitutional symptoms. Anti-tubercular therapy was initiated and patient showed marked clinical improvement on follow-up visits.[eurekaselect.com]
Cough
  • This study reports a case of a young male with fever, dry cough, reduced appetite and weight loss for one month presenting radiologically as a mediastinal mass.[eurekaselect.com]
  • Cough, fever with shivering, and night sweats are often present.[en.wikipedia.org]
  • Chronic Cough Azygo-esophageal recess Azygo-esophageal recess Bronchogenic Cysts Bronchogenic Cysts Anterior junction line Anterior junction line  Extends from thoracic inlet inferiorly and to the left  Extends from thoracic inlet inferiorly and to[learningradiology.com]
  • It has been seen that EUS is better tolerated by patients with pronounced cough, those with poor lung function or significant comorbid lung disease [ 16 ]. Our patient had none of these conditions.[omicsonline.org]
  • Three days ago, he then developed a dry cough, shallow respirations, and apparent stiffness of his neck with an inability to straighten his neck or bring his head to midline.[hawaii.edu]
Dry Cough
  • This study reports a case of a young male with fever, dry cough, reduced appetite and weight loss for one month presenting radiologically as a mediastinal mass.[eurekaselect.com]
  • We report the case of a 14-year-old boy, who presented with dry cough and progressively increasing breathlessness, and was found to have a cystic lesion in the posterior mediastinum.[lungindia.com]
  • Three days ago, he then developed a dry cough, shallow respirations, and apparent stiffness of his neck with an inability to straighten his neck or bring his head to midline.[hawaii.edu]
  • Clinical manifestations of an aspiration event fall along a diverse spectrum, including asymptomatic dry cough, dysphonia, stridor, vomiting after meals, and ARDS.[pulmonologyadvisor.com]
Painful Cough
  • These symptoms include chest pain, cough, dyspnea, fever, and purulent sputum (, 10 ).[pubs.rsna.org]
Acute Abdomen
  • abdomen and new material on CT and MR angiography, lung cancer screening, pulmonary embolism, coronary artery calcium screening, and interventional CT techniques including radiofrequency ablation and CT fluoroscopy.[books.google.com]
Chest Pain
  • A 22-year-old man, diagnosed 7 weeks before with pulmonary tuberculosis and started on antitubercular therapy, presented with non-exertional retrosternal chest pain since the past week.[ncbi.nlm.nih.gov]
  • On the following day the fever subsided, chest pain decreased and he was kept on the same antibiotic while paracetamol was stopped. Twelve days later, the WBC started to decrease and his WBC was 4300/ μl.[jcdr.net]
  • Case Report A 26-year-old male who didn’t have any underlying diseases visited the emergency room at a university hospital with fever, pleuritic chest pain, and hemoptysis that began 2 days ago.[e-sciencecentral.org]
Retrosternal Chest Pain
  • A 22-year-old man, diagnosed 7 weeks before with pulmonary tuberculosis and started on antitubercular therapy, presented with non-exertional retrosternal chest pain since the past week.[ncbi.nlm.nih.gov]
  • Retrosternal chest pain, usually described as pleuritic, may radiate to the neck or back. There may be a sensation of soreness or congestion in the neck if the condition is due to descending infection.[patient.info]
Heart Failure
  • Failure and Transplantation Cardiology Nita Ahuja MD, MBA Gastrointestinal Surgical Oncology, General Surgery, Minimally Invasive Surgery, Sarcoma and Connective Tissue Surgical Oncology Paul Aiello MD Radiology, Diagnostic Radiology Joseph Akar MD,[yalemedicine.org]
Fracture
  • BACKGROUND: Although sternal fractures after blunt chest trauma are markers for significant impact, the fracture itself is generally not associated with any specific wound complications.[ncbi.nlm.nih.gov]
  • Disorders of the mediastinum, the space between the lungs, breastbone, and spine Chest tube insertion (Medical Encyclopedia) Costochondritis (Medical Encyclopedia) Mediastinal tumor (Medical Encyclopedia) Pectus excavatum (Medical Encyclopedia) Rib fracture[icdlist.com]
Flushing
  • Needle was withdrawn and material from needle was collected directly in formalin (for cell block) and flushed with saline into sterile container for microbiological evaluation.[omicsonline.org]
Neck Edema
  • All clinicians evaluating a "sore throat" should consider neck edema or gas on neck radiograms as evidence of cervical abscess, and subsequent widening of the mediastinum on chest x-ray as an ominous sign suggesting mediastinal abscess.[ncbi.nlm.nih.gov]
  • Cricothyroidotomy is usually not a good option with in patients with massive neck edema.[utmb.edu]
Encephalopathy
  • 593 7111 Cerebral Sinovenous Thrombosis and Venous Infarction 594 7112 Arterial Infarction 595 Asparaginase Methotrexate and Cyclosporin 596 7116 EndocrineRelated Encephalopathy 597 Thoracic Emergencies 601 723 Clinical Symptoms 602 724 Imaging of Nontraumatic[books.google.com]

Workup

  • The workup should include finding the tubercular lesion. Routine blood works will show increased lymphocytes, raised ESR and CRP. Antigravity aspiration and study for tuberculous bacteria are initiated which include PCR and culture of the aspirate.[boneandspine.com]
  • Nonetheless, the practice of assigning a mediastinal mass to a specific mediastinal compartment is still useful because such a method enables one to formulate a manageable differential diagnosis and effectively direct further imaging workup, and it yields[clinicalgate.com]
  • Cardiac workup was done in view of exertional breathlessness.[jcor.in]
Mediastinal Mass
  • This report describes the 14-year natural history of a mediastinal mass with eventual abscess formation. Computed tomography provided excellent visualization, and surgical drainage afforded prompt diagnosis and treatment.[ncbi.nlm.nih.gov]
  • This study reports a case of a young male with fever, dry cough, reduced appetite and weight loss for one month presenting radiologically as a mediastinal mass.[eurekaselect.com]
  • Mediastinal mass with peripheral enhancement and central hypodensity. There is invasion/narrowing of the right main bronchus is present accounting for the right lung hyperinflation.[radiopaedia.org]
  • Keywords EBUS-TBNA; Tuberculosis mediastinal lymph node; Bronchoscopic decompression Mediastinal masses and lymphadenopathy can present with dysphagia [ 1, 2 ].[omicsonline.org]
  • Mediastinal Masses Overview The mediastinum is the most common location of chest masses in the pediatric population.[clinicalgate.com]
Capnocytophaga
  • Upon surgical drainage, Capnocytophaga spp. was the sole organism identified. This organism has been implicated in sepsis among immunocompromised hosts but has not previously been reported in this clinical setting.[ncbi.nlm.nih.gov]

Treatment

  • There is a lack of consensus on the optimal treatment for this condition.[ncbi.nlm.nih.gov]

Prognosis

  • Mediastinal abscess is a rare but life-threatening disease with grave prognosis if not recognized in time. The diagnosis of this entity is hampered by its nonspecific presentation.[ncbi.nlm.nih.gov]
  • Prognosis of Lung Abscess How is Lung Abscess Treated? Lung Abscess References What is Lung Abscess A lung abscess is a localised infection within the lung. An abscess is a pus-containing cavity.[healthengine.com.au]
  • [ edit ] Most cases respond to antibiotics and prognosis is usually excellent unless there is a debilitating underlying condition.[en.wikipedia.org]
  • Prognosis Patients with mediastinitis, empyema and purulent pericaditis should be treated with broad spectrum antibiotics, supportive care and surgical drainage. The prognosis depends on the timeliness of surgical intervention and treatment.[cancertherapyadvisor.com]
  • Treatment and prognosis Treatment is similar in principle to that of other infected collections usually requiring both surgical drainage (usually performed via a transoral route) and intravenous antibiotics.[radiopaedia.org]

Etiology

  • The diagnosis of primary gas-containing mediastinal abscess was established by the characteristic findings of computed tomography and exclusion of all the etiological possibilities.[ncbi.nlm.nih.gov]
  • Mediastinal Infection Chronic Fibrosing Mediastinitis Etiology: Chronic fibrosing mediastinitis, also known as sclerosing mediastinitis, is rare in the pediatric population.[clinicalgate.com]
  • It is thought to be due to four different etiologies: Mediastinitis at the US National Library of Medicine Medical Subject Headings (MeSH)[en.wikipedia.org]

Epidemiology

  • Epidemiology Mediastinitis is a relatively rare phenomenon in patients who have not undergone cardiothoracic surgery or another intervention.[patient.info]
  • We investigated the epidemiology of infections after lung transplantation and determined their impact on survival.[slideplayer.org]
  • Defilippi A, Silvestri M, Tacchella A et al (2008) Epidemiology and clinical features of Mycoplasma pneumoniae infection in children. Respir Med 102:1762–1768 Google Scholar 45.[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.[cancertherapyadvisor.com]
Sex distribution
Age distribution

Pathophysiology

  • We review the published literature regarding infective complications of EBUS-TBNA and propose possible pathophysiologies. These complications are likely to increase in frequency as the technique is more widely adopted.[ncbi.nlm.nih.gov]
  • 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[cancertherapyadvisor.com]

Prevention

  • The pathophysiology of this severe complication, as well as its diagnosis, management, and prevention, is discussed, together with a review of the medical scientific literature.[ncbi.nlm.nih.gov]
  • Patient was treated with Amoxicillin-clavulanate to prevent any secondary infections. Figure 3: EBUS-TBNA view. Figure 4: Aspirated pus.[omicsonline.org]
  • HIV exposure and needle stick injury prevention for health worker. National workshop on prevention of needle stick injuries for health worker, November, 2003 2003: Ascaridiose biliopancreatique. Ann Chir France Cecum fistula after appendectomy.[eng.benhvienvietduc.org]
  • Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization[books.google.de]
  • Drainage tubes are routinely placed into the infected area after irrigation and debridement in order to remove remained secretions and prevent pus collection [ 4 ].[e-sciencecentral.org]

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