Joshi Sharad, Majumdar Subhasish, Bhatia Ankit, Tayal Nitesh
Department of Pulmonary Medicine Max Super Speciality Hospital Ghaziabad India.
Department of Gastroenterology Max Super Speciality Hospital Ghaziabad India.
Respirol Case Rep. 2021 Nov 24;9(12):e0879. doi: 10.1002/rcr2.879. eCollection 2021 Dec.
We report a case of an oesophageal intramural pseudodiverticulosis leading to a mediastinal collection caused by presenting as a non-resolving pneumonia and mimicking an oesophageal mass. The patient was a 60-year-old diabetic male who was referred from another hospital and presented with a history of low-grade fever and breathlessness. His computed tomography (CT) of the chest disclosed a mediastinal mass alongside the oesophagus with pleural collection. Endobronchial ultrasound scope was inserted through the oesophagus (EUS-B) and fine-needle aspirate was taken from the mass. The cultures of specimen from the mediastinum grew drug-resistant . . The patient was managed with oral voriconazole along with oesophageal stenting after which he showed remarkable recovery. Repeat CT revealed a near-complete reduction of the mediastinal infection. The case highlights the need of a high degree of suspicion, right approach to diagnostic work-up and appropriate histopathological and microbiological examination of clinical specimens.
我们报告一例食管壁内假性憩室病导致纵隔积脓的病例，该病例最初表现为持续性肺炎并疑似食管肿物。患者为一名60岁的糖尿病男性，从另一家医院转诊而来，有低热和呼吸困难病史。其胸部计算机断层扫描（CT）显示食管旁有一个纵隔肿物伴胸腔积液。通过食管插入支气管内超声探头（EUS-B）并从肿物处进行细针抽吸。纵隔标本培养出耐药菌……患者接受口服伏立康唑及食管支架置入治疗，之后病情显著好转。重复CT显示纵隔感染几乎完全消退。该病例强调了高度怀疑的必要性、正确的诊断检查方法以及对临床标本进行适当的组织病理学和微生物学检查的重要性。
