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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]
  • Abstract Mediastinal abscess is a rare presentation of infections involving the mediastinum. In rare cases, the origin of the infection cannot be identified.[ncbi.nlm.nih.gov]
  • Here we report a 15-year-old sumo wrestler who presented with an anterior mediastinal abscess without any mediastinal fracture.[ncbi.nlm.nih.gov]
  • In these cases patients presented with interscapular back pain. In one of the cases the patient died because of the presentation was misdiagnosed hence leading to delay in the intervention.[ncbi.nlm.nih.gov]
  • Abstract A late-presenting high esophageal perforation that resulted in a massive mediastinal abscess and bronchopleural fistula in an elderly moribund patient unfit for radical surgery was successfully drained using a videothoracoscopic technique.[ncbi.nlm.nih.gov]
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]
Cough
  • Symptom Mediastinal abscess symptoms common symptoms chest pain fever with cough, slightly ... fatigue fever Patients with chills, fever, irritability and other symptoms, complained of severe pain after the sternum, deep breathing or cough when the pain[healthfrom.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
  • 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]
Chest Pain
  • Abstract 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]
  • He had never had any symptoms but complained of chest pain only after the abscess ruptured into the right thoracic cavity.[ncbi.nlm.nih.gov]
  • The main clinica manifestations are fever, chest pain, dysphagia and dyspnea. A toxic shock develops in serious cases.[ncbi.nlm.nih.gov]
  • Symptom Mediastinal abscess symptoms common symptoms chest pain fever with cough, slightly ... fatigue fever Patients with chills, fever, irritability and other symptoms, complained of severe pain after the sternum, deep breathing or cough when the pain[healthfrom.com]
  • 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]
Retrosternal Chest Pain
  • Abstract 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]
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]

Workup

  • 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]
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]
  • 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]
  • The chest X-ray performed showed a widened mediastinum (Fig. 1 ), whereas an anterior mediastinal mass sized 3.4 5 cm compatible with an abscess was identified in the thoracic computed tomography (CT; Fig. 2 a). Figure 1: Chest X-ray of the patient.[academic.oup.com]
  • 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]
  • OBJECTIVES: This study aimed to HYPERLINK "javascript:void(0);" discuss risks and benefits in treatment of mediastinal abscess by EBUS-TBNA.[ncbi.nlm.nih.gov]
  • Conservative treatment, with antibiotics, effected complete cure.[ncbi.nlm.nih.gov]
  • Mediastinitis can lead to serious and rapid deterioration of the patient's condition, for which surgical intervention is the treatment of choice.[ncbi.nlm.nih.gov]
  • Traditionally, immediate aggressive drainage is recommended via a transcervical or transthoracic approach for the treatment of a retropharyngeal abscess with mediastinal extension.[ncbi.nlm.nih.gov]

Prognosis

  • Abstract 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]
  • [ edit ] Most cases respond to antibiotics and prognosis is usually excellent unless there is a debilitating underlying condition.[en.wikipedia.org]
  • 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]
  • It has a different cause, treatment, and prognosis than acute infectious mediastinitis. Space infections: Pretracheal space – lies anterior to trachea. Pretracheal space infection leads to mediastinitis.[en.wikipedia.org]
  • Prognosis [ 11 ] A recent review found an overall mortality of 11.1% (but is up to 50% in some series). In the presence of comorbid conditions, the mortality rate may be as high as 67%.[patient.info]

Etiology

  • Injury to the hypopharynx or esophagus with child abuse as a possible etiology should be considered when an infant or young child presents with unexplained erythematous neck swelling, subcutaneous emphysema, pneumomediastinum and/or wide mediastinum.[ncbi.nlm.nih.gov]
  • 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]
  • Because radiographic evidence of abnormal calcification in the chest is common, but rarely is associated with broncholithiasis, the patient's history of lithoptysis was crucial to determining the underlying etiology of her abscess.[ncbi.nlm.nih.gov]
  • Introduction Etiology Prevention Complication Symptom Examine Diagnosis Treatment Basic Nursing Introduction Brief introduction of mediastinal abscess Mediastinal abscess refers to the lesion in the mediastinal abscess.[healthfrom.com]
  • Mediastinal Infection Chronic Fibrosing Mediastinitis Etiology: Chronic fibrosing mediastinitis, also known as sclerosing mediastinitis, is rare in the pediatric population.[clinicalgate.com]

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]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • 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]
  • In this report, we discuss the management and possible pathophysiological mechanisms of descending mediastinal infections that have an unusual cause.[ncbi.nlm.nih.gov]

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]
  • Prevention Prevention of mediastinal abscess The prevention of the disease is mainly active treatment of primary diseases, especially the pharyngeal access, pharyngeal posterior infection, should actively take anti-infective measures to prevent the occurrence[healthfrom.com]
  • Patient was treated with Amoxicillin-clavulanate to prevent any secondary infections. Figure 3: EBUS-TBNA view. Figure 4: Aspirated pus.[omicsonline.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]
  • Aggressive treatment includes surgical drainage, and medical management in an intensive care unit may prevent a catastrophic outcome.[ncbi.nlm.nih.gov]

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