Mediastinitis

Mediastinitis is a severe inflammatory condition affecting the mediastinum, the central compartment of the chest that contains the heart, major blood vessels, esophagus, trachea, and lymph nodes. It most commonly develops after cardiac surgery, chest trauma, esophageal perforation, or deep neck infections that spread into the chest. Because the infection can progress rapidly, mediastinitis is considered a medical emergency requiring immediate treatment.

Common symptoms include severe chest pain, fever, chills, difficulty breathing, rapid heart rate, fatigue, and drainage from a surgical wound in postoperative patients. Diagnosis typically involves a physical examination, blood tests, chest computed tomography (CT) scans, and microbiological cultures to identify the causative organism.

Treatment depends on the severity and underlying cause. Most patients require broad-spectrum intravenous antibiotics, surgical drainage of infected tissue, wound debridement, and supportive hospital care. In cases following heart surgery, repeated surgical exploration may be necessary to control the infection and promote healing.

Early diagnosis and aggressive management significantly improve survival rates and reduce complications such as sepsis, organ failure, or prolonged hospitalization. Preventive strategies include strict surgical sterility, proper wound care, timely treatment of infections, and close postoperative monitoring to detect early signs of mediastinal infection.