Department of Pulmonary and Critical Care Medicine, First Hospital of China Medical University, Shenyang, Liaoning, China.
J Int Med Res. 2020 May;48(5):300060520918469. doi: 10.1177/0300060520918469.
Acute mediastinitis (AM) is a rare but life-threatening disease. Here, we report a case of AM secondary to endobronchial tuberculosis (EBTB) and pseudomembranous tracheobronchitis (PMATB) co-infection. EBTB was confirmed by tissue culture for and GeneXpert MTB/RIF (Cepheid, Sunnyvale, CA, USA) detection (simultaneous detection of and resistance to rifampin) using endobronchial biopsies; PMATB was confirmed by histopathology. Even with antibiotic treatment and systemic support treatment, the patient died of massive hemoptysis on day 10 after admission. When immunocompromised hosts have AM, especially with central airway involvement, EBTB and aspergillosis should be considered potential causes. Bronchoscopy is helpful for rapid diagnosis and administering precise treatment.
急性纵隔炎（AM）是一种罕见但危及生命的疾病。在这里，我们报告了一例继发于支气管内膜结核（EBTB）和假膜性气管支气管炎（PMATB）合并感染的 AM 病例。EBTB 通过支气管内膜活检进行组织培养和 GeneXpert MTB/RIF（Cepheid，加利福尼亚州桑尼维尔）检测（同时检测 和对利福平的耐药性）得到确认；PMATB 通过组织病理学得到确认。即使接受抗生素治疗和全身支持治疗，该患者在入院后第 10 天仍因大量咯血而死亡。当免疫功能低下的宿主发生 AM 时，尤其是伴有中央气道受累时，应考虑 EBTB 和曲霉菌病作为潜在病因。支气管镜检查有助于快速诊断和实施精确治疗。
