A Case of Mediastinal Abscess Requiring Surgical Management

VernacularTitle:急性化膿性甲状腺炎に続発した降下性縦隔炎の1例
Author: Shotaro ITOH ¹ ; Kei TAKAMURA ¹ ; Hajime KIKUCHI ¹ ; Makoto YAMAMOTO ¹ ; Iwao YOSHIOKA ² ; Setsuyuki OHTAKE ³ ; Keisuke KIKUCHI ⁴
Author Information

1. Obihiro Kosei General Hospital, department of respiratory medicine
2. Obihiro Kosei General Hospital, department of otolaryngology
3. Obihiro Kosei General Hospital, department of respiratory surgery
4. Obihiro Kosei General Hospital, department of patholgy
From:Journal of the Japanese Association of Rural Medicine 2020;69(1):74-78
CountryJapan
Language:Japanese
Abstract: We report on an apparently healthy woman in her 50s who noticed pain in the left side of her neck anteriorly and was prescribed an antimicrobial agent at a nearby clinic. However, she developed hypotension and hypoxemia and was brought to our hospital. Laboratory investigations revealed evidence of inflammation, and imaging findings showed low-density areas corresponding to the left lobe of the thyroid gland. The low-density areas extended to the superior mediastinum, raising suspicion of a thyroid gland mediastinal abscess. We performed inferior mediastinal drainage with video-assisted thoracoscopic surgery and resection of the left lobe of the thyroid gland. Culture of mediastinal aspirate yielded Streptococcus viridans. Based on these findings, the final diagnosis was descent-related mediastinitis secondary to acute suppurative thyroiditis.