Thoracic surgery clinics
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Infections of the mediastinum (ie, mediastinitis) are serious, are associated with high morbidity and mortality, and may result from adjacent disease with direct extension, hematogenous spread, or direct introduction into the mediastinal space. The organs and tissues involved determine the manifestations and approach to treatment of these infections. The most common ones are those secondary to perforation of the esophagus or penetrating trauma, and those that extend from an adjacent infection. ⋯ However, these likely represent a continuum of chronic infection. In cases of acute mediastinitis, treatment should always be directed toward the primary pathology and the clinical presentation. In chronic cases, surgical treatment is only palliative.