MyMedR

Fulltext Mediastinal abscess and pericarditis complicating retropharyngeal abscess--a case report

Elango S, Edward R, Purohit GN

Med J Malaysia, 1989 Dec;44(4):348-50.

PMID: 2520047

A case of retropharyngeal abscess complicated is reported and its management is outlined. Key words: Retropharyngeal abscess,Complication, Pericardities, Mediastinal abscess

Matched MeSH terms: Mediastinal Diseases/complications*

Fatal anterior mediastinal mass in a pregnant lady

Koo ZP, Chainchel Singh MK, Mohamad Noor MHB, Omar NB, Siew SF

Forensic Sci Med Pathol, 2024 Mar;20(1):226-232.

PMID: 37436679 DOI: 10.1007/s12024-023-00669-4

We report a fatal case of a 26-year-old nulliparous woman who presented with an anterior mediastinal mass in her late pregnancy. She had complained of a progressively increasing neck swelling and occasional dry cough in the early second trimester, which was associated with worsening dyspnoea, reduced effort tolerance and orthopnoea. Ultrasound of the neck showed an enlarged lymph node, and chest X-ray revealed mediastinal widening. At 35 weeks' gestation, the patient was referred to a tertiary centre for a computed tomography (CT) scan of the neck and thorax under elective intubation via awake fibreoptic nasal intubation as she was unable to lie flat. However, she developed sudden bradycardia, hypotension and desaturation soon after being positioned supine, which required resuscitation. She succumbed after 3 days in the intensive care unit. An autopsy revealed a large anterior mediastinal mass extending to the right supraclavicular region, displacing the heart and lungs, encircling the superior vena cava and right internal jugular vein with tumour thrombus extending into the right atrium. Histopathology examination of the mediastinal mass confirmed the diagnosis of a primary mediastinal large B-cell lymphoma. This report emphasizes the severe and fatal outcome resulting from the delay and misinterpretation of symptoms related to a mediastinal mass.

Matched MeSH terms: Mediastinal Diseases*

A dedifferentiated large posterior mediastinal liposarcoma - An incidental finding successfully resected

Narasimman S, Jasjit SN, Navarasi SR, Premnath N

Med J Malaysia, 2016 08;71(4):201-202.

PMID: 27770120

This is a case of a posterior mediastinal mass in an asymptomatic gentleman, which was resected successfully and he has been disease free for more than a year of follow up. The histopathology findings happen to be a rare occurrence.

Matched MeSH terms: Mediastinal Diseases

Fulltext Hypercalcemia in a patient with tuberculous mediastinal lymphadenopathy

Tan TT, Lee BC, Zainuddin BM, Wong KT, Samad A, Khalid BA

Singapore Med J, 1991 Feb;32(1):87-9.

PMID: 2017716

We describe the case of a 48 year old Indian female with hypercalcemia due to tuberculosis. She presented with symptoms of hypercalcemia and chest radiographs showed bilateral hilar lymphadenopathy with normal lung fields. The diagnosis of tuberculosis was made histologically from biopsy of the enlarged hilar nodes. Her hypercalcemia resolved following one month of anti-tuberculous treatment. The prevalence of hypercalcemia in tuberculosis has been reported to be high in western series. There is, however, a paucity of local data on the subject. The presence of 1-alpha-hydroxylase-like activity in pulmonary alveolar macrophages with resulting increased formation of active vitamin D metabolites is the postulated mechanism of tuberculosis associated hypercalcemia.

Matched MeSH terms: Mediastinal Diseases/complications*; Mediastinal Diseases/radiography; Mediastinal Diseases/therapy

Fulltext Posterior mediastinal abscess secondary to esophageal perforation following fish bone ingestion

Ahmad R, Ishlah W, Shaharudin MH, Sathananthar KS, Norie A

Med J Malaysia, 2008 Jun;63(2):162-3.

PMID: 18942310 MyJurnal

Accidental swallowing of fish bone, which arrested in esophagus, is fairly common. However the incidence of esophageal perforation due to fish bone swallowing is low. Delayed posterior mediastinal abscess as a result of the esophageal perforation is a rare manifestation and may lead to fatal outcome. Two cases of delayed formation of posterior mediastinal abscess following esophageal perforation due to accidental fish bone ingestion are described here. In these cases patients presented with interscapular back pain. In one of the cases the patient died because of the presentation was misdiagnosed hence leading to delay in the intervention. Radiological findings and surgical management namely esophagoscopy and neck exploration are briefly described.

Matched MeSH terms: Mediastinal Diseases/etiology*

A radiological appraisal of the paravertebral shadow in diseases of the spine and mediastinum

Soo YS, Soong O

Med J Malaya, 1971 Sep;26(1):42-52.

PMID: 4258575

Matched MeSH terms: Mediastinal Diseases/radiography*

Clinical and radiological characteristics of mediastinal melioidosis: A four-year retrospective cohort from Sabah, Malaysia

Nyanti LE, Abdul Muien MZB, Abu Othman A, Chia YL, Peshi MS, Toh V, et al.

Respir Med, 2024;234:107818.

PMID: 39332778 DOI: 10.1016/j.rmed.2024.107818

BACKGROUND: Melioidosis is a potentially fatal tropical infection. Little is known about mediastinal involvement in melioidosis. This study aimed to (a) describe the prevalence and demographics of various morphologies of mediastinal melioidosis, (b) propose a classification for radiological morphologies of mediastinal melioidosis.

METHODS: A retrospective cohort study was performed. Case records of consecutive patients with culture-positive melioidosis who underwent computed tomography (CT) thorax from January 1, 2018-February 28, 2022, were reviewed.

RESULTS: 486 culture-positive melioidosis patients were identified, of which 70 underwent CT thorax. 41 patients demonstrating mediastinal involvement were included in the final analysis, of which four were mediastinal collections, while the rest were classified into those with necrotic or matted appearances, and subcentimeter and larger than 1 cm. Culture-positivity was proven from blood in 83 % of patients (n = 34), with the remaining from chest wall pus, neck abscess pus, sputum, liver abscess, seminal vesicle, pleural, pericardial and peritoneal fluid. The most commonly associated pulmonary manifestations were consolidation and pleural effusion. Half had diabetes; a quarter had chronic kidney disease, while one had syphilis. Exposure to soil was present in six patients: quarry (n = 1), construction (n = 2), farmer (n = 1), living environment (n = 2). Seven patients succumbed before the end of 6-week intensive phase antibiotic treatment.

CONCLUSION: Mediastinal melioidosis is a spectrum with multiple overlapping features consisting of necrosis, matted lymph nodes, multiseptated and non-septated collections. Further studies will elucidate the prognostic implications of mediastinal melioidosis.

Matched MeSH terms: Mediastinal Diseases/microbiology

Adult varicella zoster infection complicated with streptococcal retrosternal abscess

Yap FBB, Kiung ST

South. Med. J., 2009 Jun;102(6):653-5.

PMID: 19434036 DOI: 10.1097/SMJ.0b013e3181a49a71

A 43-year-old lady with type 2 diabetes mellitus and bronchial asthma presented with varicella zoster infection, dyspnea, and neck fullness. An urgent computed tomography scan revealed a mediastinal abscess with superior vena cava thrombus. Blood, mediastinal pus, and swab from a vesiculopustule on the neck cultured group A beta hemolytic Streptococcus. She recovered with a combination of broad spectrum antimicrobials, antivirals, and surgical drainage. This case illustrates the rare occurrence of mediastinal abscess and acute superior vena cava obstruction caused by group A beta hemolytic Streptococcus complicating adult varicella zoster.

Matched MeSH terms: Mediastinal Diseases/complications*; Mediastinal Diseases/drug therapy; Mediastinal Diseases/microbiology

Fulltext Spontaneous oesophageal perforation: a case report

Shu Ann Hon, Jan Jan Chai, Lian Thai Lee, Qin Jian Low

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):326-328.

MyJurnal

A 49-year-old gentleman presented with epigastric pain for one day associated with one episode of vomiting and dyspnoea. Respiratory examination showed reduced breath sound over his left lower zone. He was treated as left spontaneous pneumothorax and left lung empyema requiring left chest tube insertion and intravenous antibiotics. His left pleural fluid biochemistry result was exudative while its centrifuge showed empyema. In ward, we noticed food material draining from his left chest tube during feeding. An urgent contrast enhanced computed tomography (CECT) thorax showed a left oesophageal-pleural fistula with possible broncho-oesophageal fistula. During oesoph- agogastroduodenoscopy (OGDS), air bubbles were seen in his left under-water chest drainage during air-insufflation of the oesophagus. The revised diagnosis was Boerhaave syndrome. He was treated with an esophageal stent to cover the perforation and a left lung decortication via video assisted thoracoscopic surgery (VATS) for his left empyema. He improved and was discharged well.

Matched MeSH terms: Mediastinal Diseases

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