Department of Respiratory Medicine, Zhejiang Province Hospital of Traditional Chinese Medical, Hangzhou, China.
Department of Laboratory, Zhejiang Province Traditional Chinese Medical Hospital, Hangzhou, China.
BMC Pulm Med. 2020 Feb 17;20(1):43. doi: 10.1186/s12890-020-1068-3.
Descending necrotizing mediastinitis is a severe infection of the mediastinum. This syndrome manifests as fever and chest pain following cough and sputum production. A 49-year-old woman presented with fever and a 14-day history of pneumonia. CT showed mediastinal abscesses with a giant calcified mediastinal lymph node (21 × 18 mm) and pneumonia. Bronchoscopy by EBUS-TBNA under general anesthesia was performed. The pathogen found in the puncture culture was Streptococcus constellatus, and antibiotics (mezlocillin/sulbactam 3.375 IVGTT q8h) was administered. A proximal right main bronchial neoplasm, suspected lung cancer, was found and conformed to inflammatory granuloma. A total of 22 months post-discharge the patient was clinically stable. We also conducted a review of the literature for all Streptococcus constellatus descending necrotizing mediastinitis infections between 2011 and 2017.
下行性坏死性纵隔炎是一种严重的纵隔感染。该综合征表现为咳嗽和咳痰后发热和胸痛。一名 49 岁女性因发热和 14 天肺炎就诊。CT 显示纵隔脓肿，伴有巨大钙化性纵隔淋巴结（21×18mm）和肺炎。在全身麻醉下进行经支气管超声内镜引导下经支气管针吸活检术（EBUS-TBNA）。穿刺培养发现病原体为星座链球菌，给予抗生素（美洛西林/舒巴坦 3.375 静脉滴注 q8h）。发现右侧主支气管近端有一个肿瘤，疑似肺癌，符合炎症性肉芽肿。出院后 22 个月患者临床情况稳定。我们还对 2011 年至 2017 年所有星座链球菌下行性坏死性纵隔炎感染的文献进行了回顾。
