Mediastinitis

Mediastinitis refers to inflammation and infection of the mediastinum, the center compartment of the thoracic cavity located between the lungs.  Mediastinitis is associated with significant morbidity and mortality and may arise as a complication of cardiothoracic surgery or esophageal perforation.  Patients typically have chest pain, dyspnea, and systemic toxicity (eg, fever, tachycardia).  Initial management involves broad-spectrum intravenous antibiotics and prompt surgical debridement.

The mediastinum is the central compartment of the thoracic cavity and is located between the pleural sacs of the left and right lung.  It is bordered inferiorly by the diaphragm, superiorly by the thoracic inlet, posteriorly by the thoracic spine, and anteriorly by the sternum.  This space contains several vital structures, including the heart, great vessels (eg, aorta), esophagus, trachea/mainstem bronchi, thymus, thoracic duct, and lymph nodes.