Mediastinal Infections
Dr. Merve EKİNCİ, Dr. Akif TURNA

Abstract 10.5152/gghs.2020.036

Mediastinum is defined as the part of the thoracic cavity located between the two pleural cavities. Mediastinitis; although it is a rare infection of the mediastinal cavity and the organs in the media, it maintains its clinical importance among the mediastinal diseases due to its high mortality rate. The infection may have an acute subacute or chronic course. Acute mediastinal infections usually develop after cardiothoracic surgery, esophageal perforations, infections of the oropha-ryngeal region. Acute mediastinitis has high mortality rates and shows progressive features. De-scending necrotizing mediastinitis is a complication that often develops due to oropharyngeal or odontogenic severe infections. Necrotizing mediastinitis from the pattern results from the extensi-on of this infection to the mediastinum along the facial plans of the neck. It has a very fast course and is associated with high mortality rates. Mediastinitis in acute form rarely turns into chronic mediastinitis. It is also called chronic mediastinitis, granulomatous mediastinitis, fibrosing medi-astinitis and mediastinal fibrosis. The mediastinum is mainly exposed to fibrosis due to tuberculo-sis and fungal infection. Considering the underlying causes of chronic mediastinitis, histoplasmosis has been accused, especially in regions where the histoplasmosis infection is endemic, but the disease is thought to occur in the form of an immunological response in genetically susceptible individuals. Early diagnosis reduces mortality. However, there may be delays in diagnosis since patients can come with atypical findings. Clinical findings and radiological imaging are important in diagnosis. Early diagnosis, antibiotic therapy, aggressive surgical debridement and drainage are important for successful treatment. The treatment algorithm should be considered for the patient and etiology, each patient should be evaluated within the framework of his/her own conditions, and most importantly, treatment should be started immediately due to the progressive and severe clinical course of the disease after the diagnosis is cleared as soon as possible.

Keywords: Mediastinal diseases, mediastinal infections, mediastinitis.
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