MEDIASTINITIS
Acute mediastinitis is usually due to esophageal perforation or to traumatic rupture of the airway, or rarely to spread of infection from the neck or abdomen. Features are usually typical of mediastinal disease, along with fever, leukocytosis, pneumomediastinum, pneumothorax, and often a pleural effusion. Distinctive features include a high pleural fluid amylase with esophageal perforation and fracture of the first three ribs seen with bronchial rupture. Treatment includes antibiotics, surgical drainage, and closure of the perforated viscus.
Chronic mediastinitis is usually caused by a granulomatous process, most often histoplasmosis, and less frequently by other fungal infections, tuberculosis, and syphilis. Noninfectious causes include sarcoidosis and, in the past, the use of methysergide. An idiopathic cause should be considered only when specific disorders are ruled out. Treatment other than that specifically directed at the underlying disorder, such as surgery, is usually unsuccessful.
- Women’s Health Program
- Incidence
- HEART DISEASE AND PREGNANCY
- Verapamil
- CIRCULATORY PHYSIOLOGY
- Hypertrophic Cardiomyopathy
- Diagnosis
- NONATHEROSCLEROTIC CAUSES OF CORONARY ARTERY OBSTRUCTION
- EMBOLIC DISEASE
- ANTIBIOTICS
- OXYGEN
- Etiology and Pathogenesis
- DROWNING AND NEAR-DROWNING
- Neurologic Manifestations
- MOXIOUS GASES AflD FUMES
- Renal Tumors
- THE AIRWAY STRUCTURE
- The Use of Diuretics
- SMOKING CESSATION
- DIAGNOSIS AND EVALUATION
- Lidocaine
- PERIPHERAL ANEURYSMS AMD FISTULAE
- TRAMSPLATTTATION
- Disopyramide
- NONOBSTRUCTIVE CAUSES OF ISCHEMIC HEART DISEASE
- Outcomes of Dialysis
- Potassium Homeostasis
- Miscellaneous
- PULMOIIARY FUNCTION EVALUATION
- Hepatic Diseases
- Endocrine Systems
- Aminoaciduria
- Uremic Osteodystrophy
- RENAL PARENCHYMAL
- THE APPROACH TO THE PATIENT WITH GASTROINTESTINAL HEMORRHAGE