Mediastinitis: Difference between revisions
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==Management== | ==Management== | ||
* ''Patients with mediastinitis emergently require surgery'' | * ''Patients with mediastinitis emergently require surgery'' | ||
* Start broad-spectrum antibiotics to include Pseudomonal coverage | * Start broad-spectrum antibiotics to include Pseudomonal coverage<ref>El Oakley, RM et al. Postoperative mediastinitis: classification and management. Ann Thorac Surg. 1996. PMID 8619682</ref> | ||
==Disposition== | ==Disposition== | ||
Revision as of 06:18, 18 April 2014
Background
- A serious infection of the mediastinum with significant morbidity and mortality[1] and generally requires surgery
Clinical Features
- Chest Pain
- Signs of Sepsis
- Hamman sign on auscultation of precordium (crunch heard during systole)
Etiology
- Prior cardiovascular surgery (most common cause)
- Esophageal rupture (Boerhaave Syndrome)
- Ludwig Angina
- Thoracic Trauma
- Lung infection extension
Workup
- Septic workup to include:
- CBC
- Blood cultures
- Gram Stain
- Cultures of mediastinal pacing wires
- CT if diagnosis in doubt
Management
- Patients with mediastinitis emergently require surgery
- Start broad-spectrum antibiotics to include Pseudomonal coverage[2]
Disposition
- Admit
See Also
Sources
Medscape: Mediastinitis Treatment & Managemen. Mueller DK, et al.