Mediastinitis Overview
Learn About Mediastinitis
Mediastinitis is swelling and irritation (inflammation) of the chest area between the lungs (mediastinum). This area contains the heart, large blood vessels, windpipe (trachea), food tube (esophagus), thymus gland, lymph nodes, and connective tissue.
Chest infection
Mediastinitis usually results from an infection. It may occur suddenly (acute), or it may develop slowly and get worse over time (chronic). It most often occurs in person who recently had an upper endoscopy or chest surgery.
A person may have a tear in their esophagus that causes mediastinitis. Causes of the tear include:
- A procedure such as upper GI endoscopy
- Forceful or constant vomiting
- Trauma
Other causes of mediastinitis include:
- A fungal infection called histoplasmosis
- Radiation to the chest
- Inflammation of the lymph nodes, lungs, liver, eyes, skin, or other tissues (sarcoidosis)
- Tuberculosis
- Breathing in anthrax
- Cancer
Risk factors include:
- Disease of the esophagus
- Diabetes mellitus
- Problems in the upper gastrointestinal tract
- Recent chest surgery or upper GI endoscopy
- Weakened immune system
Symptoms may include:
- Chest pain
- Chills
- Fever
- General discomfort
- Shortness of breath
Signs of mediastinitis in people who have had recent surgery include:
- Chest wall tenderness
- Wound drainage
- Unstable chest wall
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.
Roswell Park Cancer Institute
Chukwumere Nwogu is a Thoracic Surgeon in Buffalo, New York. Dr. Nwogu and is rated as an Experienced provider by MediFind in the treatment of Mediastinitis. His top areas of expertise are Lung Cancer, Pleuropulmonary Blastoma, Non-Small Cell Lung Cancer (NSCLC), Vagotomy, and Endoscopy.
Andrew Steehler is an Otolaryngologist in Erie, Pennsylvania. Dr. Steehler and is rated as an Experienced provider by MediFind in the treatment of Mediastinitis. His top areas of expertise are Retropharyngeal Abscess, Mediastinitis, Nasal Polyps, and Spasmodic Dysphonia.
Shaun Morris practices in Toronto, Canada. Morris and is rated as an Experienced expert by MediFind in the treatment of Mediastinitis. His top areas of expertise are Multisystem Inflammatory Syndrome in Children (MIS-C), Zika Virus Disease, Typhoid Fever, and Severe Acute Respiratory Syndrome (SARS).
How well a person does depends on the cause and severity of the mediastinitis.
Mediastinitis after chest surgery is very serious. There is a risk of dying from the condition.
Complications include the following:
- Spread of the infection to the bloodstream, blood vessels, bones, heart, or lungs
- Scarring
Scarring can be severe, especially when it is caused by chronic mediastinitis. Scarring can interfere with heart or lung function.
Contact your provider if you have had open chest surgery and develop:
- Chest pain
- Chills
- Drainage from the wound
- Fever
- Shortness of breath
If you have a lung infection or sarcoidosis and develop any of these symptoms, see your provider right away.
To lessen the risk of developing mediastinitis related to chest surgery, surgical wounds should be kept clean and dry after surgery.
Treating tuberculosis, sarcoidosis, or other conditions associated with mediastinitis may prevent this complication.
Summary: In cardiac surgery patients, due to the surgical burden combined with existing comorbidities, evaluating the preoperative clinical status of patients and predicting mortality rates has become an important issue of interest for clinicians. For this purpose, mortality has been predicted with various scoring systems. EUROSCORE is a scoring system used worldwide that predicts preoperative mortality fo...
Summary: Mediastinitis is the most feared infectious complication after cardiac surgery. Several risk factors are known such as: obesity, diabetes, chronic obstructive pulmonary disease, double breast sampling, immunodeficiency, corticosteroid therapy, reoperation, chest radiotherapy, and dialysis. Three modes of contamination are described: intraoperative contamination, hematogenous dissemination during s...
Published Date: September 10, 2022
Published By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Lentz RJ, Loyd JE. Mediastinitis and fibrosing mediastinitis. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 116.
Van Schooneveld TC, Rupp ME. Mediastinitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 85.