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.

Clinical Presentation


Diagnostic Workup


Pathophysiology


Treatments


Prevention


Outcome & Complications


Differential Diagnoses


Medical Disclaimer: The content on this site is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you think you may be experiencing a medical emergency, call 911 or your local emergency number immediately. Always consult a licensed healthcare professional with questions about a medical condition.

Artificial Intelligence Use: Portions of this site’s content were generated or assisted by AI and reviewed by Erik Romano, MD; however, errors or omissions may occur.

Analytics Disclosure: If you allow analytics cookies, Doctogenic uses Google Analytics, Microsoft Application Insights, and Microsoft Clarity to understand site usage, diagnose issues, review heatmaps and session replay recordings, and improve the service on pages where those tools are enabled. Clarity is not enabled on account, purchase, billing, checkout, Stripe-related, or admin pages. You can change this choice through Cookie preferences.

USMLE® is a registered trademark of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). Doctogenic and Roscoe & Romano are not affiliated with, sponsored by, or endorsed by the USMLE, FSMB, or NBME. Neither FSMB nor NBME has reviewed or approved this content. "USMLE Step 1" and "USMLE Step 2 CK" are used only to identify the relevant examinations.