Mediastinitis: Difference between revisions
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==Background== | ==Background== | ||
* A serious infection of the mediastinum with significant morbidity and mortality and generally requires surgery | * A serious infection of the mediastinum with significant morbidity and mortality<ref>Infections of the mediastinum. | ||
SB - Thorac Surg Clin 2009 Feb; PMID 19288819 </ref> and generally requires surgery | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 05:42, 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
- 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
See Also
Sources
- ↑ Infections of the mediastinum. SB - Thorac Surg Clin 2009 Feb; PMID 19288819