Purulent mediastinitis

By Dr. Diana West
Updated 2024-03-06 16:56:58 | Published 2023-07-04 00:52:04
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    • Explore the Diseases category on iMedix for comprehensive insights into various health conditions. This section offers detailed information on symptoms, causes, treatments, and preventive measures, providing a valuable resource for understanding and managing health challenges.

An abstract illustration of Purulent Mediastinitis

Purulent mediastinitis is an inflammation and infection of the mediastinum, which is the space in the middle of the chest between the lungs that contains various structures such as the heart, blood vessels, esophagus, and thymus gland. This condition occurs when bacteria or other infectious agents invade the mediastinum, leading to the accumulation of pus (purulent fluid).


What is purulent mediastinitis?

Purulent mediastinitis is a severe infection of the mediastinum, the central compartment in the thoracic cavity. It's characterized by the accumulation of pus and is often a complication of esophageal perforations or chest surgeries.

What are the symptoms of purulent mediastinitis?

Symptoms include severe chest pain, fever, rapid heart rate, shortness of breath, difficulty swallowing, and general malaise. In advanced cases, symptoms may include signs of sepsis or shock.

How is purulent mediastinitis diagnosed?

Diagnosis typically involves imaging studies like chest X-rays, CT scans, or MRI, along with blood tests to check for infection. Esophagoscopy or bronchoscopy may also be conducted to investigate the source of infection.

What causes purulent mediastinitis?

The most common causes are esophageal perforations, often due to surgical procedures, injuries, or ingestion of corrosive substances. It can also result from spread of infection from nearby organs, such as the lungs or airways.

What is the treatment for purulent mediastinitis?

Treatment typically involves surgical drainage of the infected area, removal of necrotic tissue, and administration of broad-spectrum antibiotics. Supportive care for breathing and circulation may also be necessary.

Can purulent mediastinitis lead to complications?

Yes, it can lead to severe complications like sepsis, septic shock, respiratory failure, and multi-organ dysfunction. Early and aggressive treatment is crucial to prevent these serious outcomes.

What is the prognosis for purulent mediastinitis?

The prognosis depends on the severity of the infection, the patient's overall health, and how quickly treatment is initiated. With prompt and appropriate care, the prognosis can be favorable, but delays in treatment can lead to poor outcomes.


  • Fever
  • Chest pain
  • Difficulty breathing
  • Rapid heartbeat
  • Fatigue
  • Productive cough with purulent sputum
  • Sweating
  • Swelling or tenderness in the chest area


Purulent mediastinitis can be caused by:

  • Spread of infection from nearby structures, such as the lungs or throat
  • Direct contamination during surgery or invasive medical procedures in the chest area
  • Foreign body penetration or ingestion
  • Esophageal or paraesophageal perforation

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To diagnose purulent mediastinitis, healthcare professionals may perform the following:

  • Physical examination
  • Imaging tests, such as X-rays, CT scans, or MRI
  • Blood tests to check for signs of infection
  • Analysis of pus or fluid samples


Treatment for purulent mediastinitis usually involves:

  • Administration of antibiotics to target the specific bacteria causing the infection
  • Drainage of the pus through surgical procedures
  • Supportive care to manage symptoms and promote healing

It's important to seek prompt medical attention if symptoms of purulent mediastinitis arise, as this condition can be serious and potentially life-threatening if left untreated.

Purulent Mediastinitis


  • Infection spreading from nearby sites, such as the lungs, neck, or chest
  • Complications from surgeries or medical procedures in the chest or upper abdomen
  • Esophageal perforation
  • Sternum or rib fractures
  • Pre-existing infections, such as pneumonia or empyema
  • Weakened immune system
  • Foreign objects or substances entering the mediastinum

Purulent mediastinitis

  • Infection in the chest cavity
  • Pain or discomfort in the chest
  • Fever and chills
  • Difficulty breathing
  • Chest tightness or pressure
  • Coughing up blood or pus
  • Rapid heartbeat
  • Shortness of breath
  • Sweating
  • Frequent urge to urinate
  • Weight loss
  • General feeling of illness
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