Diferencia entre revisiones de «Mediastinitis»
| Línea 4: | Línea 4: | ||
==Clinical Features== | ==Clinical Features== | ||
* Chest Pain | * [[Chest Pain (DDX)|Chest Pain]] | ||
* Signs of [[Sepsis]] | * Signs of [[Sepsis]] | ||
* Hamman sign on auscultation of precordium (crunch heard during systole) | * Hamman sign on auscultation of precordium (crunch heard during systole) | ||
Revisión del 05:51 18 abr 2014
Background
- A serious infection of the mediastinum with significant morbidity and mortality[1] and generally requires surgery
Clinical Features
- Chest Pain
- Signs of Sepsis
- Hamman sign on auscultation of precordium (crunch heard during systole)
Etiology
- Prior cardiovascular surgery (most common cause)
- Esophageal rupture (Boerhaave Syndrome)
- Ludwig Angina
- Thoracic Trauma
- Lung infection extension
Workup
- Septic workup to include:
- CBC
- Blood cultures
- Gram Stain
- Cultures of mediastinal pacing wires
- CT if diagnosis in doubt
Management
- Patients with mediastinitis require surgery
- Start broad-spectrum antibiotics to include Pseudomonal coverage
Disposition
- Admit
See Also
Sources
- ↑ Infections of the mediastinum. SB - Thorac Surg Clin 2009 Feb; PMID 19288819