Candida mediastinitis and septic shock following occult esophageal perforation in a patient with posttraumatic quadriplegia.
Unexplained septic shock was ultimately shown to be caused by Candida mediastinitis after perforation of the cervical esophagus by a dislodged cervical methylmethacrylate construct in a 25-year-old patient with traumatic quadriplegia. Communication between the prevertebral abscess and pleural space further led to the formation of a esophageal-pleural-cervical fistula. Despite antibiotics, surgical removal of the construct, and drainage of the esophagus and mediastinum, the patient died from refractory shock and respiratory failure.
D000328:Adult; D001858:Bone Nails / Q000009:adverse effects; D002177:Candidiasis / Q000209:etiology*; D004947:Esophagus / Q000293:injuries*; D017809:Fatal Outcome; D005548:Foreign-Body Migration / Q000150:complications; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology*; D011782:Quadriplegia / Q000601:surgery*; D012772:Shock, Septic / Q000209:etiology*; D013119:Spinal Cord Injuries / Q000601:surgery*; D014950:Wounds, Penetrating / Q000209:etiology