1.A Case of Mediastinal Abscess Requiring Surgical Management
Shotaro ITOH ; Kei TAKAMURA ; Hajime KIKUCHI ; Makoto YAMAMOTO ; Iwao YOSHIOKA ; Setsuyuki OHTAKE ; Keisuke KIKUCHI
Journal of the Japanese Association of Rural Medicine 2020;69(1):74-78
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.
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