Mediastinitis: Difference between revisions
| Line 9: | Line 9: | ||
==Etiology== | ==Etiology== | ||
* Prior cardiovascular surgery (most common cause) | * Prior cardiovascular surgery (most common cause) | ||
* [[Esophageal | * [[Esophageal Perforation|Esophageal rupture (Boerhaave Syndrome)]] | ||
* [[Ludwig Angina]] | * [[Ludwig Angina]] | ||
* Trauma | * Trauma | ||
Revision as of 05:39, 18 April 2014
Background
- A serious infection of the mediastinum with significant morbidity and mortality 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
- 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 require surgery
- Start broad-spectrum antibiotics to include Pseudomonal coverage
Disposition
- Admit