Mediastinitis: a life-threatening complication of acute tonsillitis

Bell, Zoraida Rodríguez; Menezes, Alicia; Primrose, W. J.; McGuigan, James A.

doi:10.1258/0022215054797853

Cited by 10 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Serious and rare complications of tonsillitis are well described in the literature 1–3. Mediastinitis as a consequence of these complications has been described numerous times,4–6 however, intramural oesophageal abscess as a result of tonsillitis has not, to our knowledge, been documented.…”

Section: Discussionmentioning

confidence: 99%

Intramural oesophageal abscess: an unusual complication of tonsillitis

et al. 2019

View full text Add to dashboard Cite

Tonsillitis is an extremely common condition, usually it is self-limiting, of viral origin, and managed conservatively in general practice. Rarely patients require inpatient management, usually when bacterial infection is present or when the cause is virulent organisms such as Epstein Barr virus. Complications can be divided into non-suppurative; sepsis, scarlet fever, rheumatic fever, glomerulonephritis and Lemierres disease, and suppurative; quinsy, parapharyngeal abscess and retropharyngeal abscess, respectively. Anecdotally, there is concern that modern medical practice that counsels vigilance against overuse of antibiotics, could lead to increased complications of tonsillitis. We report a case of an otherwise healthy man who presented with dysphagia, odynophagia and neck pain following a sore throat. Despite antibiotic treatment he developed an intramural oesophageal abscess, to our knowledge, an unreported complication of tonsillitis.

show abstract

Section: Discussionmentioning

confidence: 99%

Intramural oesophageal abscess: an unusual complication of tonsillitis

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Further difficulties were related to the nature of the diagnosis itself. Mediastinal infection is rare, and mediastinitis, when subacute, frequently presents in a subtle fashion 23 24. It is likely that that this response was further dampened by immunosuppression.…”

Section: Discussionmentioning

confidence: 99%

A case of severe staphylococcal septicaemia: septic arthritis and a mediastinal abscess following leflunamide therapy for rheumatoid arthritis

Balasanthiran

Vakilgilani²,

Darzy³

et al. 2010

Case Reports

View full text Add to dashboard Cite

SummaryThis highly unusual case illustrates how a potentially life-threatening complication may develop insidiously in the context of immunosuppression.A 46-year-old woman presented with increasing malaise and a marked inflammatory response in the context of immunosuppressive therapy for rhueumatoid arthritis. On the basis of microbiological findings, the patient was treated for systemic staphylococcal infection with a prolonged antibiotic course. In addition, incision and drainage procedures were performed on associated, non-resolving abscesses at various sites. One particular lesion in the breast was slow to heal and was monitored with ultrasound imaging. Subsequent cross-sectional imaging revealed that this was, in fact, a large mediastinal abscess, eroding the manubrium and lying within close proximity of the aorta. The patient was eventually referred to a cardiothoracic unit for complete evacuation of this lesion. Following a prolonged illness and treatment period, the patient recovered well and successfully resumed employment. BACKGROUND

show abstract

“…Lebenjahr [3]. Mechanische Atemwegsobstruktionen, Aspiration von Pus durch spontane Abszesseröffnung, Arrosion großer Halsgefäße oder eine Thrombophlebitis der V. Jugularis interna mit septischen Verläufen (Lemierre-Syndrom) können Folge derartiger oropharyngealer Abszesse sein [1,4,5]. Die von einem tonsillogenen Fokus ausgehende abszedierende Entzündung kann sich außerdem entlang der Halsfaszien nach kaudal ausbreiten und zur Mediastinitis führen.…”

unclassified