Mediastinitis Classification and external resources ICD-10 J98.5 ICD-9 519.2 DiseasesDB 7909 MedlinePlus 000081 eMedicine med/2798 MeSH D008480
Acute mediastinitis is usually bacterial and due to rupture of organs in the mediastinum. As the infection can progress rapidly, this is considered a serious condition. Chronic sclerosing (or fibrosing) mediastinitis, while potentially serious, is caused by a long-standing inflammation of the mediastinum, leading to growth of acellular collagen and fibrous tissue within the chest and around the central vessels and airways. It has a different cause, treatment, and prognosis than acute infectious mediastinitis.
Causes and treatment
Before the development of modern cardiovascular surgery, cases of acute mediastinitis usually arose from either perforation of the esophagus or from contiguous spread of odontogenic or retropharyngeal infections. However, in modern practice, most cases of acute mediastinitis result from complications of cardiovascular or endoscopic surgical procedures.
Treatment usually involves aggressive intravenous antibiotic therapy and hydration. If discrete fluid collections (such as abscesses) or grossly infected tissue have formed, they may have to be surgically drained or debrided.
Chronic mediastinitis is usually a radiologic diagnosis manifested by diffuse fibrosis of the soft tissues of the mediastinum. This is sometimes the consequence of prior granulomatous disease, most commonly histoplasmosis. Other identifiable causes include tuberculosis and radiation therapy. Fibrosing mediastinitis most frequently causes problems by constricting blood vessels or airways in the mediastinum. This may result in such complications as superior vena cava syndrome or pulmonary edema from compression of pulmonary veins.
Treatment for chronic fibrosing mediastinitis is somewhat controversial, and may include steroids or surgical decompression of affected vessels.
- -6684651 at GPnotebook
- MeSH Mediastinitis
- Fibrosing Mediastinitis
- Fibrosing Mediastinitis Jason's Site
- Tami Jo's Site on FM
- Mediastinal Germ Cell Tumors
Pathology of respiratory system (J, 460–519), respiratory diseases Upper RT
Common cold)Headvocal folds: Laryngopharyngeal reflux (LPR) · Vocal fold nodule · Vocal cord paresis · Vocal cord dysfunction
Lower RT/lung disease
(including LRTIs)acute: Acute bronchitischronic: COPD (Chronic bronchitis, Acute exacerbations of chronic bronchitis, Acute exacerbation of COPD, Emphysema) · Asthma (Status asthmaticus, Aspirin-induced, Exercise-induced) · BronchiectasisInterstitial/
restrictiveBy pathogenBy vector/routeBy distributionBroncho- · LobarOther
mediastinumMediastinal diseaseMediastinitis · Mediastinal emphysema
Other/general Inflammation Acute Chronic Processes Specific locationsCardiovascularDigestivemouth (Stomatitis, Gingivitis, Gingivostomatitis, Glossitis, Tonsillitis, Sialadenitis/Parotitis, Cheilitis, Pulpitis, Gnathitis) · tract (Esophagitis, Gastritis, Gastroenteritis, Enteritis, Colitis, Enterocolitis, Duodenitis, Ileitis, Caecitis, Appendicitis, Proctitis) · accessory (Hepatitis, Cholangitis, Cholecystitis, Pancreatitis) · Peritonitis
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