Chest infection DefinitionMediastinitis 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. CausesMediastinitis 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: Other causes of mediastinitis include:
Risk factors include:
SymptomsSymptoms may include:
Signs of mediastinitis in people who have had recent surgery include:
Exams and TestsThe health care provider will perform a physical exam and ask about symptoms and medical history. Tests may include: The provider may insert a needle into the area of inflammation. This is to obtain a sample to send for Gram stain and culture to determine the type of infection, if present. TreatmentYou 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. Outlook (Prognosis)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. Possible ComplicationsComplications include the following:
Scarring can be severe, especially when it is caused by chronic mediastinitis. Scarring can interfere with heart or lung function. When to Contact a Medical ProfessionalContact your provider if you have had open chest surgery and develop:
If you have a lung infection or sarcoidosis and develop any of these symptoms, see your provider right away. PreventionTo 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. ReferencesLentz 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. | |
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Review Date: 9/10/2022 Reviewed 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. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. | |
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Respiratory system
Mediastinum
