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Definition

Mediastinitis is swelling and irritation (inflammation) of the area between the lungs (mediastinum). This area contains the heart, large blood vessels, windpipe (trachea), esophagus, thymus gland, lymph nodes, and connective tissues.

Alternative Names

Chest infection

Causes, incidence, and risk factors

Mediastinitis may occur suddenly (acute) or may develop slowly and get worse over time (chronic). Most cases occur in patients who have had open chest surgery. Less than 5 percent of patients develop mediastinitis after having chest surgery.

Patients may have a tear in their esophagus that causes mediastinitis. Causes of the tear include:

Other causes of mediastinitis include:

Risk factors include:

  • Problems in the upper gastrointestinal tract
  • Recent chest surgery or endoscopy
  • Weak immune system
SymptomsSigns and tests

Signs of mediastinitis in patients who have had recent surgery include:

  • Chest wall tenderness
  • Wound drainage
  • Unstable chest wall

Tests include:

Your health care provider may insert a needle into the area of inflammation and remove a sample to send for gram stain and culture to find the source of any infection.

Treatment

You may receive antibiotics if you have an infection.

You may need surgery to remove the area of inflammation if the blood vessels, windpipe, or esophagus is blocked.

Expectations (prognosis)

How well a person does depends on the cause of the mediastinitis.

Mediastinitis after open chest surgery is very serious. There is a significant risk of dying from the condition.

Complications

Complications include the following:

  • Spread of the infection to the:
    • Bloodstream
    • Blood vessels
    • Bones
    • Heart
    • Lungs
  • Scarring

Scarring can be severe, especially when it is caused by chronic mediastinitis. Scarring can interfere with heart or lung function.

Calling your health care provider

Contact your health care provider if you have had open chest surgery and develop:

  • Chest pain
  • Chills
  • Drainage from the wound
  • Fever
  • Shortness of breath

If you have tuberculosis, histoplasmosis, or sarcoidosis and develop any of these symptoms, contact your health care provider right away.

Prevention

The only way to prevent mediastinosis related to chest surgery is to keep surgical wounds clean and dry after surgery.

Treating tuberculosis, sarcoidosis, or other conditions associated with mediastinitis may prevent this complication.

References

Park DR, Vallieres E. Pneumomediastinum and mediastinitis. In: Mason RJ, Murray J, Broaddus VC, Nadel J, eds. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2005: chap 72.

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Definition

Mediastinitis is swelling and irritation (inflammation) of the area between the lungs (mediastinum). This area contains the heart, large blood vessels, windpipe (trachea), esophagus, thymus gland, lymph nodes, and connective tissues.

Alternative Names

Chest infection

Causes, incidence, and risk factors

Mediastinitis may occur suddenly (acute) or may develop slowly and get worse over time (chronic). Most cases occur in patients who have had open chest surgery. Less than 5 percent of patients develop mediastinitis after having chest surgery.

Patients may have a tear in their esophagus that causes mediastinitis. Causes of the tear include:

Other causes of mediastinitis include:

Risk factors include:

  • Problems in the upper gastrointestinal tract
  • Recent chest surgery or endoscopy
  • Weak immune system
SymptomsSigns and tests

Signs of mediastinitis in patients who have had recent surgery include:

  • Chest wall tenderness
  • Wound drainage
  • Unstable chest wall

Tests include:

Your health care provider may insert a needle into the area of inflammation and remove a sample to send for gram stain and culture to find the source of any infection.

Treatment

You may receive antibiotics if you have an infection.

You may need surgery to remove the area of inflammation if the blood vessels, windpipe, or esophagus is blocked.

Expectations (prognosis)

How well a person does depends on the cause of the mediastinitis.

Mediastinitis after open chest surgery is very serious. There is a significant risk of dying from the condition.

Complications

Complications include the following:

  • Spread of the infection to the:
    • Bloodstream
    • Blood vessels
    • Bones
    • Heart
    • Lungs
  • Scarring

Scarring can be severe, especially when it is caused by chronic mediastinitis. Scarring can interfere with heart or lung function.

Calling your health care provider

Contact your health care provider if you have had open chest surgery and develop:

  • Chest pain
  • Chills
  • Drainage from the wound
  • Fever
  • Shortness of breath

If you have tuberculosis, histoplasmosis, or sarcoidosis and develop any of these symptoms, contact your health care provider right away.

Prevention

The only way to prevent mediastinosis related to chest surgery is to keep surgical wounds clean and dry after surgery.

Treating tuberculosis, sarcoidosis, or other conditions associated with mediastinitis may prevent this complication.

References

Park DR, Vallieres E. Pneumomediastinum and mediastinitis. In: Mason RJ, Murray J, Broaddus VC, Nadel J, eds. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2005: chap 72.

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The insertion and removal of the endoscope may stimulate a gag reflex, and can cause some discomfort. The procedure may also irritate the tissues of the nose and throat, causing a nosebleed or coughing.

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Muslims believe that one of their roles in this life is to do good for mankind and to explore their planet. That is why they were encouraging science and research. Of these contributions in medicine are:

  • Development of psychotherapy and other therapeutic methods.
  • Research work on smallpox and measles.
  • Production of medical treatment and medical drugs.
  • Extensive research on properties of scores of drugs.
  • Distinguished mediastinitis from pleurisy.
  • Recognized the contagious nature of disease and ability of disease to spread to water and soil.
  • Discover the existence of blood capillaries.
  • Use and discussion of animal Psychology and physiology.
  • Constructed magnificent, well organized, and well equipped hospitals that, at that time, were unrivaled in the world and whose doors were open for all the public.
  • Provided the first detailed study of the human eye.
  • Discovered the use of chemistry for medical purposes.
  • Establishment of the first apothecary shop.
  • Production of the first pharmacopeadia.
  • The first to discover and identify three chief acids : nitric, sulfuric, and hydrochloric.
  • Discovered the arts of distillation, crystallization, and oxidation.
  • Classified substances into mineral, vegetable, and animal origin.
View page

Muslims believe that one of their roles in this life is to do good for mankind and to explore their planet. That is why they were encouraging science and research. Of these contributions in medicine are:

  • Development of psychotherapy and other therapeutic methods.
  • Research work on smallpox and measles.
  • Production of medical treatment and medical drugs.
  • Extensive research on properties of scores of drugs.
  • Distinguished mediastinitis from pleurisy.
  • Recognized the contagious nature of disease and ability of disease to spread to water and soil.
  • Discover the existence of blood capillaries.
  • Use and discussion of animal Psychology and physiology.
  • Constructed magnificent, well organized, and well equipped hospitals that, at that time, were unrivaled in the world and whose doors were open for all the public.
  • Provided the first detailed study of the human eye.
  • Discovered the use of chemistry for medical purposes.
  • Establishment of the first apothecary shop.
  • Production of the first pharmacopeadia.
  • The first to discover and identify three chief acids : nitric, sulfuric, and hydrochloric.
  • Discovered the arts of distillation, crystallization, and oxidation.
  • Classified substances into mineral, vegetable, and animal origin.
View page

Muslims believe that one of their roles in this life is to do good for mankind and to explore their planet. That is why they were encouraging science and research. Of these contributions in medicine are:

  • Development of psychotherapy and other therapeutic methods.
  • Research work on smallpox and measles.
  • Production of medical treatment and medical drugs.
  • Extensive research on properties of scores of drugs.
  • Distinguished mediastinitis from pleurisy.
  • Recognized the contagious nature of disease and ability of disease to spread to water and soil.
  • Discover the existence of blood capillaries.
  • Use and discussion of animal Psychology and physiology.
  • Constructed magnificent, well organized, and well equipped hospitals that, at that time, were unrivaled in the world and whose doors were open for all the public.
  • Provided the first detailed study of the human eye.
  • Discovered the use of chemistry for medical purposes.
  • Establishment of the first apothecary shop.
  • Production of the first pharmacopeadia.
  • The first to discover and identify three chief acids : nitric, sulfuric, and hydrochloric.
  • Discovered the arts of distillation, crystallization, and oxidation.
  • Classified substances into mineral, vegetable, and animal origin.
View page
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