Mediastinitis presenting as pyrexia of unknown origin.
A 55 year old female was admitted as a case of pyrexia of unknown origin (PUO) of 2 months duration. She had developed throat ache, progressive dysphagia for both solids and liquids, dry cough and retrosternal pain for one week. Examination revealed fever, tachycardia, tachypnoea and a soft tissue warm tender, erythematous, non-fluctuant swelling in lower anterior neck with chest findings suggestive of bilateral pleural effusion. Plain X-rays of the neck and chest strengthened the clinical suspicion of cellulitis of lower neck with bilateral pleural effusion. CT scan confirmed the radiologic findings and also revealed pericardial effusion and thickening; small mediastinal lymphadenopathy and mediastinitis. Patient responded to parenteral antibiotics (ceftriaxone and metronidazole) and hydrocortisone with complete resolution in 10 days.
Prakash
A
A
Department of Medicine, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi-110 002.
Singh
N P
NP
Makhija
A
A
Garg
D
D
Kubba
S
S
Agarwal
S K
SK
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D005260:Female; D005335:Fever of Unknown Origin / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007194:India; D008480:Mediastinitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D002443:Ceftriaxone