5,136 results match your criteria Mediastinitis


Sternotomy with electrocautery and sternal wound infection in congenital heart surgery in patients under 1 year of age.

J Card Surg 2021 Apr 24. Epub 2021 Apr 24.

Department of Cardiovascular Surgery, Başkent University, Ankara, Turkey.

Objective: The present study aimed to compare the rate of wound site infection in patients <1 year of age who underwent sternotomy using electrocautery, a routinely performed procedure in our clinic, with those reported in the literature.

Methods: This double-center study included patients <1 year of age who underwent cardiac surgery via sternotomy performed with electrocautery for congenital heart disease between January 2017 and June 2019. Patient's data were retrospectively obtained from the hospital records. Read More

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Interlocking Multi-Twisted Wires Versus Interrupted Simple Sternal Wires for Closure of Median Sternotomy.

Heart Surg Forum 2021 04 12;24(2):E363-E368. Epub 2021 Apr 12.

Cardiothoracic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Background: Although closure of a sternotomy incision is usually a simple procedure, failure to do so (sternal dehiscence) is a serious complication and is an independent factor that poses a high degree of morbidity or mortality after open heart surgery. Instability of the bone fragments can lead to complete sternal breakdown, sternal wound infection, and mediastinitis. The stainless-steel encircling wire used as either interrupted simple sutures or as figure of eight sutures is the current standard method of median sternotomy closure. Read More

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Mediastinal mature teratoma with chest pain onset and subsequent perforation: A case report.

Int J Surg Case Rep 2021 Apr 26;81:105807. Epub 2021 Mar 26.

Department of Thoracic Surgery, Yamanashi University, 1110 Shimkato, Chuo-shi, Yamanashi, Japan. Electronic address:

Introduction: Mediastinal mature teratomas are often benign, asymptomatic, and incidentally detected during routine chest roentgenography. Enzymes secreted by intestinal or pancreatic tissue in teratomas may lead to mediastinitis or the rupture of adjacent tissues. Herein, we present a case of a patient who experienced sudden onset of chest pain followed by the perforation of a mediastinal teratoma. Read More

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Late outcome after surgical and topical treatment for Aspergillus mediastinitis after heart transplantation.

J Card Surg 2021 Apr 21. Epub 2021 Apr 21.

Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland.

The 7-year long-term survival after Aspergillus fumigatus mediastinitis after heart transplantation, an uncommonly described condition, is herein reported. A 66-year-old male developed an infection with A. fumigatus covering the entire thoracic cavity with a fungal turf after orthotopic heart transplantation. Read More

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The management of deep sternal wound infection: Literature review and reconstructive algorithm.

JPRAS Open 2021 Jun 6;28:77-89. Epub 2021 Mar 6.

Department of Plastic Surgery, Royal Free London NHS Foundation Trust, Pond Street, London, United Kingdom.

Deep sternal wound infection (DSWI) is an important complication of open thoracic surgery, with a reported incidence of 0.5-6%. Given its association with increased morbidity, mortality, inpatient duration, financial burden, and re-operation rates, an aggressive approach to treatment is mandated. Read More

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Periapical abscess progressing to parotitis and descending necrotizing mediastinitis with thoracic abscess in a patient on etanercept: A case report.

Int J Crit Illn Inj Sci 2020 Oct-Dec;10(4):220-223. Epub 2020 Dec 29.

Department of Emergency Medicine, Vidant Medical Center, East Carolina University Brody School of Medicine, Greenville, NC, USA.

Patients on Type 2 biologics, such as etanercept, are at increased risk for aggressive infections. This may be further exacerbated by concomitant systemic corticosteroid use or comorbidities such as diabetes. We report a case of a patient with rheumatoid arthritis on etanercept with poor dentition and periodontal disease, who developed parotitis with peritonsillar abscess and descending necrotizing mediastinitis (DNM) with periaortic abscess arising from a periapical abscess. Read More

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December 2020

Clinical analysis of 71 spontaneous pneumomediastinum cases: an observational study from a tertiary care hospital in Japan.

Respir Investig 2021 Apr 10. Epub 2021 Apr 10.

Department of Respiratory Medicine, Yodogawa Christian Hospital, Osaka, Japan.

Background: Spontaneous pneumomediastinum is characterized by the presence of interstitial air in the mediastinum without any underlying disease. Some cases of spontaneous pneumomediastinum have been reported in the past, although only few reports are available, and its management remains uncertain. This study reviewed our experience in the diagnosis and treatment of spontaneous pneumomediastinum. Read More

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Society of Thoracic Surgeons 2021 Adult Cardiac Surgery Risk Models for Multiple Valve Operations.

Ann Thorac Surg 2021 Apr 9. Epub 2021 Apr 9.

Duke University, Durham, North Carolina.

Background: The STS Quality Measurement Task Force has developed risk models and composite performance measures for isolated coronary artery bypass grafting surgery (CABG), isolated aortic valve replacement (AVR), isolated mitral valve replacement or repair (MVRR), AVR+CABG, and MVRR+CABG. To further enhance its portfolio of risk-adjusted performance metrics, STS has developed new risk models for multiple valve operations +/- CABG procedures.

Methods: Using July 2011 to June 2019 STS Adult Cardiac Surgery Database (ACSD) data, risk models for AVR+MVRR (n=31,968) and AVR+MVRR+CABG (n=12,650) were developed with the following endpoints: operative mortality, major morbidity (any one or more of the following: cardiac reoperation; deep sternal wound infection/mediastinitis; stroke; prolonged ventilation; and renal failure), and combined mortality and/or major morbidity. Read More

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Mortality following deep sternal wound infection-not just a short-term complication?

Eur J Cardiothorac Surg 2021 Apr 11. Epub 2021 Apr 11.

Division of Cardiac Surgery, Swedish Heart and Vascular Institute, Seattle, WA, USA.

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ECMO POST-CARDIOTOMY, A SINGLE CENTRE EXPERIENCE.

Rev Port Cir Cardiotorac Vasc 2021 Apr 8;28(1):19-23. Epub 2021 Apr 8.

Cardiothoracic Surgery Department - Centro Hospitalar Universitário de São João, Portugal.

Objectives: Our objective was to examine the results of ECMO post cardiotomy in Centro Hospitalar Universitário S. João (CHUSJ).

Methods: Between 2011 and 2019, 13 patients were cannulated for refractory cardiogenic shock post-cardiotomy; 8 (61,5%) male and 5 (38,5%) female. Read More

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[Immunoglobulin G4( IgG4)-related Fibrosing Mediastinitis Localized in the Retrosternal Area:Report of a Case].

Kyobu Geka 2021 Apr;74(4):317-320

Department of Thoracic Surgery, Kanazawa Medical Center, Kanazawa, Japan.

An 84-year-old man was referred to our out-patient clinic with an elongated mass localized to the retrosternal area that was incidentally identified by computed tomography. On 18F-fluorodeoxyglucose-positron emission tomography, this lesion showed intense tracer uptake. Thus, a surgical biopsy under thoracoscopy was performed. Read More

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[Descending Necrotizing Mediastinitis with Empyema Necessitated Two Performances of Surgical Drainage for Successful Treatment:Report of a Case].

Kyobu Geka 2021 Apr;74(4):313-316

Department of Surgery, Kagawa Prefectural Shirotori Hospital, Higashikagawa, Japan.

The case was a 57-year-old woman. She visited a local doctor with a chief complaint of sore throat. A retropharyngeal abscess was suspected, and she was referred to our otolaryngology. Read More

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[Diagnosis and treatment of 12 patients with deep neck infection and inferior mediastinal infection].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Apr;35(4):324-327

Department of Otolaryngology Head and Neck Surgery,Zhongshan Hospital Affiliated to Sun Yat-sen University,Zhongshan People's Hospital,Zhongshan,528403,China.

To summarize the clinical manifestations and treatment of patients with deep neck infection with descending mediastinal infection. The clinical data of 12 patients with deep neck infection with descending mediastinal infection were reviewed. The clinical manifestations, infection origin, bacterial culture results, related systemic diseases, surgical drainage methods and treatment results were analyzed. Read More

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Case Report: F-FDG PET-CT for Diagnosing Prosthetic Device-Related Infection in an Infant With CHD.

Front Pediatr 2021 8;9:584741. Epub 2021 Mar 8.

Department of Pediatrics, Kagoshima University, Kagoshima, Japan.

Patients who have undergone cardiac surgery using prosthetic devices have an increased risk of developing prosthetic device-related infection and mediastinitis. However, accurate diagnosis of prosthetic device-related infection can be difficult to evaluate and treat with antibiotic therapy alone. In recent years, F-fluorodeoxyglucose positron emission tomography-computed tomography (F-FDG PET-CT) has made promising contributions to detect infective endocarditis, pacemaker infections, or other inflammations. Read More

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[Treatment of postoperative anterior mediastinitis, sternal osteomyelitis in a patient with a novel coronavirus infection].

Khirurgiia (Mosk) 2021 (4):53-57

Hospital for War Veterans, Russia, St. Petersburg.

The incidence of mediastinitis after median sternotomy makes up 1-3%. This complication results prolonged hospital-stay, significant increase in treatment cost and high mortality (up to 75%). Severe COVID-19 pneumonia is often manifested by coughing, that impairs sternum stability after osteosynthesis. Read More

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Streptococcus anginosus group infection as a predictor for the progression of descending necrotizing mediastinitis.

Ann Palliat Med 2021 Mar 22. Epub 2021 Mar 22.

Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, Tokyo, Japan.

Background: The prognosis of descending necrotizing mediastinitis (DNM), especially that extending inferiorly to the carina, remains poor. The identification of additional prognostic factors may improve the prognosis.

Methods: We retrospectively analyzed six patients who underwent thoracic surgery for DNM extending to the anterior and posterior mediastinum inferior to the carina (Endo classification type IIB) from 2014 to 2020. Read More

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The association between preoperative length of hospital stay and deep sternal wound infection: A scoping review.

Aust Crit Care 2021 Mar 6. Epub 2021 Mar 6.

School of Health, Federation University Australia, Berwick, Melbourne, VIC 3806, Australia; Australian Institute of Primary Care and Ageing, La Trobe University, Melbourne, VIC 3086, Australia. Electronic address:

Background: Deep sternal wound infection (DSWI) is a serious complication of cardiac surgery, associated with a significantly longer hospital stay, an increased mortality, and an almost doubling of treatment costs. The preoperative length of hospital stay has been suggested in a small number of studies as a modifiable risk factor yet is not included in surgical site infection prevention guidelines. The aim of this scoping review was to review the existing evidence on the association between preoperative length of hospital stay and DSWI, and to identify established risk factors for DSWI. Read More

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Complete lung collapse as a rare complication of sarcoidosis-associated mediastinal lymphadenopathy.

Respirol Case Rep 2021 Apr 10;9(4):e00739. Epub 2021 Mar 10.

Department of Pulmonology, Critical Care, and Sleep Medicine Mayo Clinic health System Eau Claire WI USA.

Complete lung collapse associated with sarcoidosis is exceedingly rare. Although lymphoma should be ruled out when patients with mediastinal lymphadenopathy develop lung collapse, sarcoidosis should be considered in the differential, especially when associated with fibrosing mediastinitis. Read More

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Central venoarterial extracorporeal life support in pediatric refractory septic shock: a single center experience.

Perfusion 2021 Mar 15:2676591211001782. Epub 2021 Mar 15.

Division of Pediatric Critical Care Medicine, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.

Objective: Venoarterial extracorporeal membrane oxygenation (VA ECMO) is recognized as a potential support therapy for pediatric patients with refractory septic shock (RSS). This review aims to report our experience with central VA cannulation in pediatric patients with RSS, and to compare this with peripheral VA ECMO cannulations for this condition at our institution.

Design: Retrospective case series. Read More

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Ascending Necrotizing Mediastinitis. An Exceptional Case.

Arch Bronconeumol 2021 Feb 15. Epub 2021 Feb 15.

UGC de Cuidados Intensivos, Hospital Universitario Virgen del Rocío, Sevilla, España.

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February 2021

Fibrosing Mediastinitis Associated With Tuberculosis in Children.

Pediatr Infect Dis J 2021 Apr;40(4):e166-e169

From the Pediatric Pulmonology Unit, Department of Pediatrics, Advanced Pediatrics Centre.

Two children developed fibrosing mediastinitis following past tuberculosis disease. Both were microbiologically negative for tuberculosis at presentation. One was treated with steroids and supportive therapy, but developed active tuberculosis with complications. Read More

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A new classification of descending necrotizing mediastinitis and surgical strategies.

Ann Transl Med 2021 Feb;9(4):356

Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Clinical Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Background: Descending necrotizing mediastinitis (DNM) is an inflammation occurring in the oropharynx and descending to the deep cervical space and mediastinum, which is a serious infectious disease. The investigation of a new classification system and treatment methods for DNM is still necessary.

Methods: A total of 139 patients with DNM caused by odontogenic or pharyngeal infection were retrospectively analyzed in last 20 years in the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. Read More

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February 2021

Immune reconstitution inflammatory syndrome in mediastinitis: When clinical judgment trumps imaging.

Int J Mycobacteriol 2021 Jan-Mar;10(1):82-84

Division of Infectious Diseases, Lankenau Medical Center, Wynnewood, PA, USA.

Mycobacterium chimaera has been described in postoperative cardiovascular procedures in patients after an outbreak of contaminated 3T heater-cooler units. Immune reconstitution inflammatory syndrome (IRIS) has been mostly reported in immunocompromised patients, especially HIV after starting therapy. Our case is a 52-year-old immunocompetent male who was diagnosed with M. Read More

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Circumferential esophageal perforation resulting in tension hydropneumothorax in a patient with septic shock.

Acute Crit Care 2021 Mar 11. Epub 2021 Mar 11.

Department of Internal Medicine, Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA.

Esophageal perforations occur traumatically or spontaneously and are typically associated with high mortality rates. Early recognition and prompt management are essential. We present the case of a 76-year-old man who was admitted to the medical intensive care unit with fulminant Clostridium difficile colitis, shock, and multi-organ failure. Read More

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Finding the bubble: atypical and unusual extrapulmonary air in the chest.

Radiologia 2021 Mar 4. Epub 2021 Mar 4.

Servicio de radiodiagnóstico, Hospital Vall de Hebron, Barcelona, España.

Objective: To describe the radiologic findings of extrapulmonary air in the chest and to review atypical and unusual causes of extrapulmonary air, emphasizing the importance of the diagnosis in managing these patients.

Conclusion: In this article, we review a series of cases collected at our center that manifest with extrapulmonary air in the thorax, paying special attention to atypical and uncommon causes. We discuss the causes of extrapulmonary according to its location: mediastinum (spontaneous pneumomediastinum with pneumorrhachis, tracheal rupture, dehiscence of the bronchial anastomosis after lung transplantation, intramucosal esophageal dissection, Boerhaave syndrome, tracheoesophageal fistula in patients with esophageal tumors, bronchial perforation and esophagorespiratory fistula due to lymph-node rupture, and acute mediastinitis), pericardium (pneumopericardium in patients with lung tumors), cardiovascular (venous air embolism), pleura (bronchopleural fistulas, spontaneous pneumothorax in patients with malignant pleural mesotheliomas and primary lung tumors, and bilateral pneumothorax after unilateral lung biopsy), and thoracic wall (infections, transdiaphragmatic intercostal hernia, and subcutaneous emphysema after lung biopsy). Read More

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Monitoring the Impact of Aggressive Glycemic Intervention during Critical Care after Cardiac Surgery with a Glycemic Expert System for Nurse-Implemented Euglycemia: The MAGIC GENIE Project.

J Diabetes Sci Technol 2021 Mar;15(2):251-264

Division of Endocrinology, Medicine Service Line, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.

A novel, multi-dimensional protocol named GENIE has been in use for intensive insulin therapy (IIT, target glucose <140 mg/dL) in the surgical intensive care unit (SICU) after open heart surgery (OHS) at VA Pittsburgh since 2005. Despite concerns over increased mortality from IIT after the publication of the NICE-SUGAR Trial, it remains in use, with ongoing monitoring under the MAGIC GENIE Project showing that GENIE performance over 12 years (2005-2016) aligns with the current consensus that IIT with target blood glucose (BG) <140 mg/dL is advisable only if it does not provoke severe hypoglycemia (SH). Two studies have been conducted to monitor glucometrics and outcomes during GENIE use in the SICU. Read More

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Identification of risk factors for mortality and delayed oral dietary intake in patients with open drainage due to deep neck infections: A nationwide study using a Japanese inpatient database.

Head Neck 2021 Mar 2. Epub 2021 Mar 2.

Department of Otolaryngology Head and Neck Surgery, Kansai Medical University, Hirakata, Japan.

Backgrounds: Data on risk factors for deep neck infection including descending necrotizing mediastinitis (DNM) have been limited. Using a nationwide database, the aim was identifying the factors related to patient death and delay in recovering oral intake.

Methods: Data of 4949 patients were extracted from a Japanese inpatient database between 2012 and 2017. Read More

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Tonsillitis, tonsillectomy, and deep neck space infections in England: the case for a new guideline for surgical and non-surgical management.

Ann R Coll Surg Engl 2021 Mar;103(3):208-217

The Rotherham Foundation Trust, Moorgate Road, Rotherham.

Introduction: Tonsillectomy is a common surgical procedure performed chiefly for recurrent tonsillitis. The Scottish Intercollegiate Guidance Network (SIGN) introduced guidelines in 1998 to improve patient selection for tonsillectomy and reduce the potential harm to patients from surgical complications such as haemorrhage. Since the introduction of the guidance, the number of admissions for tonsillitis and its complications has increased. Read More

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A case of cervical fasciitis complicated by mediastinitis and pre-peritoneal abscess: the role of video-assisted thoracoscopic surgery.

Indian J Thorac Cardiovasc Surg 2021 Mar 5;37(2):195-199. Epub 2020 Sep 5.

Unit of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Apuane Hospital, Via E. Mattei 31, 54100 Massa, Italy.

Cervical necrotizing fasciitis (CNF) is the name for a group of bacterial infections characterized by necrosis of the fascia and subcutaneous cellular tissue of the neck. Descending necrotizing mediastinitis (DNM) is a well-known and feared complication of CNF that severely affects the prognosis. Abdominal involvement is rare. Read More

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Short- and long-term mortality after deep sternal wound infection following cardiac surgery: experiences from SWEDEHEART.

Eur J Cardiothorac Surg 2021 Feb 24. Epub 2021 Feb 24.

Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland.

Objectives: Deep sternal wound infection (DSWI) is a serious complication after open-heart surgery. We investigated the association between DSWI and short- and long-term all-cause mortality in a large well-defined nationwide population.

Methods: A retrospective, nationwide cohort study, which included 114 676 consecutive patients who underwent coronary artery bypass grafting (CABG) and/or valve surgery from 1997 to 2015 in Sweden. Read More

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February 2021