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Mediastinitis is a serious and life-threatening infection of the mediastinum, which can be caused by esophageal ruptures, heart surgery, or other factors. Symptoms include fever, chest pain, and shortness of breath. Treatment involves antibiotics and surgical intervention.
Mediastinitis in an infection of the mediastinum, which is the area between the lungs that contains the heart, windpipe, esophagus, larynx, and connective tissues. It is a serious and life-threatening condition. A delay in diagnosis or treatment can lead to death.
This condition often occurs due to a perforation or tear in the esophagus. Esophageal ruptures can occur during medical procedures such as bronchoscopy or endoscopy or as a result of constant or violent vomiting. Patients may experience breakages after receiving a traumatic injury to the neck or chest. Other causes include taking lye, ingesting button-cell batteries, or taking certain pills.
Mediastinitis can also occur after heart surgery. Patients who have cancer, sarcoidosis or tuberculosis are at high risk of developing the condition. Other risk factors — such as upper gastrointestinal tract infections, a weakened immune system, and infections of the teeth, gums, ears, or sinuses — can contribute to mediastinitis. Males of all ethnicities who are 30-50 years old are in the highest risk category.
Affected patients experience symptoms such as fever and chills, shortness of breath, chest pain or tenderness, and a general feeling of ill health. Patients may also feel confused or have throat pain. Some patients become seriously ill within hours, and others experience symptoms for several days before seeking medical attention.
The pathogens streptococcus, staphylococcus, and pseudomonas, among many others, cause mediastinitis. The disease can spread rapidly through blood vessels and infect the bloodstream and other parts of the body. It causes significant scarring that interferes with the ability of the heart and lungs to function normally.
Doctors can usually diagnose mediastinitis fairly easily, given the patient’s medical history. The doctor inserts a needle into the infected site to collect a culture and find out what type of infection the patient has. He or she confirms the findings through X-rays, magnetic resonance imaging (MRI), or computed tomography (CT) scans.
Patients who develop mediastinitis after recently undergoing chest surgery should reopen and drain the surgical wound. The doctor will remove dead or damaged tissue and put the patient on antibiotics. Patients who develop mediastinitis after suffering a tear or rupture of the esophagus will need to repair the damaged area and drain the infected area. Your doctor will prescribe antibiotics such as ceftriaxone and clindamycin to clear up the infection. Patients usually require four to six weeks of antibiotic therapy.
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