Mediastinitis
Overview
Plain-Language Overview
Mediastinitis is a serious infection that affects the area in the middle of the chest called the mediastinum, which contains the heart, major blood vessels, and other vital structures. This condition usually occurs after surgery, injury, or infection spreading from nearby areas like the throat or lungs. It causes severe chest pain, fever, and difficulty breathing, which can quickly become life-threatening if not treated. The infection leads to inflammation and swelling in the chest, which can interfere with the function of the heart and lungs. Because the mediastinum is a central part of the body, mediastinitis can affect many important organs and requires urgent medical attention.
Clinical Definition
Mediastinitis is an acute or chronic inflammation of the mediastinal tissues, typically caused by bacterial infection following esophageal perforation, thoracic surgery (especially cardiac surgery), or descending necrotizing infections from the neck. The condition involves the spread of infection into the mediastinal space, leading to necrosis, abscess formation, and systemic sepsis. Common pathogens include Staphylococcus aureus, Streptococcus species, and anaerobes. Clinically, it presents with severe chest pain, fever, tachycardia, and signs of systemic toxicity. The condition is a surgical emergency due to the risk of rapid progression to septic shock and multiorgan failure. Early recognition and aggressive management are critical to reduce morbidity and mortality.