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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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Cranial Nerve VI Palsy Emergency

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miércoles, 28 de septiembre de 2016

Mediastinitis

emDocs - September 26, 2016 - Authors: Macdonald C, Scoccimarro A and Waseem M
 Edited by: Alex Koyfman A and Long B
Pearls/Pitfalls
  • Generally, patients with mediastinitis have manifestations of systemic infection, such as fever, chills, etc.
  • Do not delay administering antibiotics if mediastinitis is suspected.
  • Initial diagnosis is often clinical; no single test can confirm this diagnosis.
  • Any surgical procedure on the neck, including tracheostomy, could result in mediastinitis.
  • Post-sternotomy mediastinitis may mimic acute myocardial infarction.
  • Hodgkin’s disease may resemble sclerosing mediastinitis.
  • Fibrosing mediastinitis may result in superior vena cava syndrome.
  • Fibrosing mediastinitis may mimic sarcoidosis.
  • Mediastinitis may result in airway compromise; consider early protection of the airway.
  • Mediastinitis may be mistaken for many conditions, such as pneumonia, acute coronary syndrome, etc.
  • Spontaneous esophageal rupture may be mistaken for an abdominal catastrophe.
  • Consider tertiary center referral, if resources are not optimal.
  • The key to an optimal outcome is early diagnosis and aggressive treatment.