Fulminant Descending Mediastinitis, Bilateral Empyema And Respiratory Failure: A Rare Complication Of Infectious Mononucleosis (IM)

Chandak, Twinkle; Wong, Patrick; Hussain, Erfan; Kim, Angela

doi:10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a5703

Cited by 2 publications

(3 citation statements)

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“…It has been postulated that EBV infection results in transient immunosuppression due to a decrease in T cell-mediated immunity, which may predispose to a secondary bacterial superinfection, possibly resulting in peritonsillar abscess. DM could then arise by progressive infection, or following breakthrough of an abscess into the retropharyngeal or lateropharyngeal space [ 3 ]. Unlike previous cases, there was no evidence of peritonsillar abscess in our patient, suggesting secondary infection of the tonsils with progressive spread as the likely mechanism.…”

Section: Discussionmentioning

confidence: 99%

Fulminant descending mediastinitis secondary to infectious mononucleosis

Fuller

Rao

2018

Journal of Surgical Case Reports

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Descending mediastinitis is a rare, life-threatening condition caused by contiguous spread of oropharyngeal or cervical infection into the mediastinum. Infectious mononucleosis generally results in a self-limited illness characterized by fever, pharyngitis and lymphadenopathy. We present an exceptional case of an 18-year-old with infectious mononucleosis complicated by progressive bacterial superinfection and fulminant descending mediastinitis. After resuscitation, broad spectrum antibiotics, critical care support and definitive surgical management, they made a full recovery.

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Section: Discussionmentioning

confidence: 99%

Fulminant descending mediastinitis secondary to infectious mononucleosis

Fuller

Rao

2018

Journal of Surgical Case Reports

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“…Klinikai esetismertetések alapján ritkán súlyos szeptikus szövődményeket: arthritist, osteomyelitist, változatos elhelyezkedésű lágyrész-és intracranialis abscessust okozhat [3]. Empyema [4], pericarditis [5], mediastinitis [6], májabscessus [7], sőt keratitis [8] kapcsán is leírták már kóroki szerepét. Az Eikenella szepszis lassan progrediáló, de magas mortalitású kórkép.…”

Section: Megbeszélésunclassified

“…Az Eikenella szepszis lassan progrediáló, de magas mortalitású kórkép. Kialakulását a behatolási kapu nyálkontak-tusa előzi meg: gyakran a köröm rágása [9], vagy más kórokozó által kiváltott tonsillitis [6], vagy akár tonsillectomia formájában. Immunszupprimált állapot, diabetes mellitus hajlamosíthat a kifejlődésére [9].…”

Section: Megbeszélésunclassified

Empyema thoracis, hemorrhagic pericarditis and acalculous cholecystitis caused byEikenella corrodenssepsis

et al. 2013

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A szerzők 29 éves nőbetegük esetét ismertetik, akinél a garatmandulák sebészi eltávolítása után egy hónappal bal oldali empyemával szövődött tüdőgyulladás és pericarditis alakult ki. Kórokozóként Eikenella corrodenst azonosítot-tak a thoracotomiából végzett dekortikáció és empyemakiürítéssel nyert mellkasi folyadék tenyésztése során. A beteget célzott antibiotikus kezelést követően tünet-és panaszmentesen emittálták. Kórházi távozását követő egy hónap után heveny felhasi panaszokkal került sürgősséggel a sebészeti osztályra. Ekkor acalculosus cholecystitis mellett pericardialis punkciót igénylő haemorrhagiás pericarditist észleltek. A polyserositisszel járó kórképet a ritkán előforduló Eikenella corrodens okozta szepszissel magyarázták. A beteg két alkalommal végzett pericardiocentesis és célzott antibiotikus, nem szteroid gyulladáscsökkentő és mycosis kialakulása miatt antimycoticus kezelés mellett egy hónap után gyógyultan hagyta el az intézményt, és azóta is tünet-és panaszmentes. Orv. Hetil., 2013, 154(47), 1873-1876. Kulcsszavak: empyema, haemorrhagiás pericarditis, Eikenella corrodens, acalculosus cholecystitis Empyema thoracis, hemorrhagic pericarditis and acalculous cholecystitis caused by Eikenella corrodens sepsisThe authors present a case of a 29-year-old woman who was diagnosed with pneumonia in the left side complicated with pleural effusion and hemorrhagic pericarditis one month after she had undergone tonsillectomy. Eikenella corrodens was identifi ed as pathogenic agent when the empyema was removed during thoracotomy. After the patient was given antibiotic treatment she was discharged from the hospital without any symptoms or complaints. However, one month after she had left the hospital she was readmitted to the surgical unit as an emergency because of acute abdominal complaints. On admission acalculous cholecystitis as well as hemorrhagic pericarditis requiring pericardiocentesis were also observed. A rare cause of sepsis, Eikenella corrodens was identifi ed which resulted in a severe disorder including polyserositis. Pericardiocentesis was performed two times and the patient was given targeted antibiotics and non-steroidal anti-infl ammatory drugs. She was also treated with antimycotics as she had developed mycosis. After one month the patient recovered and was discharged from the hospital. No further recurrence of symptoms or complaints was observed during follow up.

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Fulminant Descending Mediastinitis, Bilateral Empyema And Respiratory Failure: A Rare Complication Of Infectious Mononucleosis (IM)

Cited by 2 publications

References 0 publications

Fulminant descending mediastinitis secondary to infectious mononucleosis

Fulminant descending mediastinitis secondary to infectious mononucleosis

Empyema thoracis, hemorrhagic pericarditis and acalculous cholecystitis caused byEikenella corrodenssepsis

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