title: A case of anterior mediastinitis and bilateral multiple lung abscesses occurring after trans-subxiphoid video-assisted thoracoscopic extended thymectomy for thymoma with myasthenia gravis.
abstract: A 68-year-old female was admitted to our hospital with an acute episode of chest pain, progressive cough and fever. She underwent trans-subxiphoid video-assisted thoracoscopic extended thymectomy (TsVATET) for thymoma with myasthenia gravis (MG) 9 days ago. Chest computed tomography (CT) showed anterior mediastinal oedema, and infiltrative findings involved bilateral lung. Physical examination revealed the subxiphoid wound suppuration. We diagnosed subxiphoid incision infection, anterior mediastinitis and concomitant bilateral pneumonia. Using antibiotics intravenously combined with anterior mediastinum irrigation and drainage, she felt well but bilateral multiple lung abscesses were discovered on the 12thday of hospitalisation. After conservative treatment with antibiotics and wound care, the recovery was satisfactory and she discharged home. In our experience, because the subxiphoid incision, the anterior mediastinum and the bilateral thoracic cavity communicated directly after TsVATET, we should be aware of the risk of anterior mediastinitis, the infection of bilateral pleural cavity, pneumonia and multiple lung abscesses following subxiphoid incision infection.
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Hanlu
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Yingcai
authors.initials: Y
authors.lastname: Geng
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
keywords: Mediastinitis; lung abscess; myasthenia gravis; thymectomy