BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuMediastinitisChest infectionMediastinitis 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. Causes Mediastinitis 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.AcuteAcute means sudden. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.ImageRead Article Now Book Mark Article ChronicChronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quick...ImageRead Article Now Book Mark Article A person may have a tear in their esophagus that causes mediastinitis. Causes of the tear include:A procedure such as upper GI endoscopy EndoscopyEndoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...ImageRead Article Now Book Mark Article Forceful or constant vomiting VomitingNausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...ImageRead Article Now Book Mark Article TraumaOther causes of mediastinitis include:A fungal infection called histoplasmosis HistoplasmosisHistoplasmosis is an infection that occurs from breathing in the spores of the fungus Histoplasma capsulatum.ImageRead Article Now Book Mark Article Radiation to the chest RadiationRadiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.ImageRead Article Now Book Mark Article Inflammation of the lymph nodes, lungs, liver, eyes, skin, or other tissues (sarcoidosis) SarcoidosisSarcoidosis is a disease in which inflammation occurs in the lymph nodes, lungs, liver, eyes, skin, and/or other tissues.ImageRead Article Now Book Mark Article Tuberculosis TuberculosisPulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.ImageRead Article Now Book Mark Article Breathing in anthrax CancerCancerCancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.Read Article Now Book Mark Article Risk factors include:Disease of the esophagus Diabetes mellitus Problems in the upper gastrointestinal tract Recent chest surgery or upper GI endoscopy Weakened immune system Symptoms Symptoms may include:Chest pain Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Chills Fever General discomfort Shortness of breathShortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Signs of mediastinitis in people who have had recent surgery include:Chest wall tenderness Wound drainage Unstable chest wall Exams and Tests The health care provider will perform a physical exam and ask about symptoms and medical history. Tests may include:Chest CT scan or MRI scan Chest CT scanA chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....ImageRead Article Now Book Mark Article MRI scanA chest MRI (magnetic resonance imaging) scan is an imaging test that uses powerful magnetic fields and radio waves to create pictures of the chest (...ImageRead Article Now Book Mark Article Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article UltrasoundUltrasoundUltrasound uses high-frequency sound waves to make images of organs and structures inside the body.ImageRead Article Now Book Mark Article 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.Gram stainThe pleural fluid Gram stain is a test to diagnose bacterial infections in or around the lungs.ImageRead Article Now Book Mark Article CulturePleural fluid culture is a test that examines a sample of fluid that has been collected in the pleural space to see if you have an infection to help ...ImageRead Article Now Book Mark Article Treatment You 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 Complications Complications include the following:Spread of the infection to the bloodstream, blood vessels, bones, heart, or lungs ScarringScarring can be severe, especially when it is caused by chronic mediastinitis. Scarring can interfere with heart or lung function. When to Contact a Medical Professional Contact your provider if you have had open chest surgery and develop:Chest pain Chills Drainage from the wound Fever Shortness of breathIf you have a lung infection or sarcoidosis and develop any of these symptoms, see your provider right away. Prevention To lessen the risk of developing mediastinitis related to chest surgery, surgical wounds should be kept clean and dry after surgery.Kept clean and dryAn incision is a cut through the skin made during surgery. It is also called a "surgical wound. " Some incisions are small. Others are very long. ...Read Article Now Book Mark Article Treating tuberculosis, sarcoidosis, or other conditions associated with mediastinitis may prevent this complication.Open ReferencesReferencesLentz 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.AllVideoImagesTogRespiratory system - illustration Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.Respiratory systemillustrationMediastinum - illustration Mediastinoscopy is a procedure in which a lighted instrument (mediastinoscope) is inserted through a neck incision to visually examine the structures in the top of the chest cavity and take tissue samples. This procedure can be used to biopsy lymph nodes surrounding the airway to help diagnose or see how far a particular disease has spread.MediastinumillustrationRespiratory system - illustration Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.Respiratory systemillustrationMediastinum - illustration Mediastinoscopy is a procedure in which a lighted instrument (mediastinoscope) is inserted through a neck incision to visually examine the structures in the top of the chest cavity and take tissue samples. This procedure can be used to biopsy lymph nodes surrounding the airway to help diagnose or see how far a particular disease has spread.MediastinumillustrationRelated Information Acute(Special Topic)Chronic(Special Topic)Nausea and vomiting – adults(Symptoms)Endoscopy(Medical Test)Pulmonary tuberculosis(Condition)Histoplasmosis(Condition)Cancer(Condition)Sarcoidosis(Condition) 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. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
MediastinitisChest infectionMediastinitis 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. Causes Mediastinitis 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.AcuteAcute means sudden. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.ImageRead Article Now Book Mark Article ChronicChronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quick...ImageRead Article Now Book Mark Article A person may have a tear in their esophagus that causes mediastinitis. Causes of the tear include:A procedure such as upper GI endoscopy EndoscopyEndoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...ImageRead Article Now Book Mark Article Forceful or constant vomiting VomitingNausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...ImageRead Article Now Book Mark Article TraumaOther causes of mediastinitis include:A fungal infection called histoplasmosis HistoplasmosisHistoplasmosis is an infection that occurs from breathing in the spores of the fungus Histoplasma capsulatum.ImageRead Article Now Book Mark Article Radiation to the chest RadiationRadiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.ImageRead Article Now Book Mark Article Inflammation of the lymph nodes, lungs, liver, eyes, skin, or other tissues (sarcoidosis) SarcoidosisSarcoidosis is a disease in which inflammation occurs in the lymph nodes, lungs, liver, eyes, skin, and/or other tissues.ImageRead Article Now Book Mark Article Tuberculosis TuberculosisPulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.ImageRead Article Now Book Mark Article Breathing in anthrax CancerCancerCancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.Read Article Now Book Mark Article Risk factors include:Disease of the esophagus Diabetes mellitus Problems in the upper gastrointestinal tract Recent chest surgery or upper GI endoscopy Weakened immune system Symptoms Symptoms may include:Chest pain Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Chills Fever General discomfort Shortness of breathShortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Signs of mediastinitis in people who have had recent surgery include:Chest wall tenderness Wound drainage Unstable chest wall Exams and Tests The health care provider will perform a physical exam and ask about symptoms and medical history. Tests may include:Chest CT scan or MRI scan Chest CT scanA chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....ImageRead Article Now Book Mark Article MRI scanA chest MRI (magnetic resonance imaging) scan is an imaging test that uses powerful magnetic fields and radio waves to create pictures of the chest (...ImageRead Article Now Book Mark Article Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article UltrasoundUltrasoundUltrasound uses high-frequency sound waves to make images of organs and structures inside the body.ImageRead Article Now Book Mark Article 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.Gram stainThe pleural fluid Gram stain is a test to diagnose bacterial infections in or around the lungs.ImageRead Article Now Book Mark Article CulturePleural fluid culture is a test that examines a sample of fluid that has been collected in the pleural space to see if you have an infection to help ...ImageRead Article Now Book Mark Article Treatment You 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 Complications Complications include the following:Spread of the infection to the bloodstream, blood vessels, bones, heart, or lungs ScarringScarring can be severe, especially when it is caused by chronic mediastinitis. Scarring can interfere with heart or lung function. When to Contact a Medical Professional Contact your provider if you have had open chest surgery and develop:Chest pain Chills Drainage from the wound Fever Shortness of breathIf you have a lung infection or sarcoidosis and develop any of these symptoms, see your provider right away. Prevention To lessen the risk of developing mediastinitis related to chest surgery, surgical wounds should be kept clean and dry after surgery.Kept clean and dryAn incision is a cut through the skin made during surgery. It is also called a "surgical wound. " Some incisions are small. Others are very long. ...Read Article Now Book Mark Article Treating tuberculosis, sarcoidosis, or other conditions associated with mediastinitis may prevent this complication.Open ReferencesReferencesLentz 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.