Open AccessIndolent form of mediastinitis caused by oesophageal perforation from fish bone ingestion
Author(s) -
Alessandro Wasum Mariani,
Paulo Manuel Pêgo-Fernandes,
Marcos Naoyoki Samano,
Euclides Furtado de Albuquerque Cavalcanti,
Juan José Cevasco,
Maurício Daniel Gattaz
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.11.2008.1250
Subject(s) - fish bone , medicine , mediastinitis , ingestion , perforation , rare disease , radiology , surgery , sepsis , disease , fish <actinopterygii> , materials science , fishery , metallurgy , punching , biology
Mediastinitis caused by oesophageal perforation usually presents as a severe disease that can quickly progress to sepsis and death. We report a case with an indolent form of mediastinitis, caused by fish bone ingestion, which was successfully and exclusively treated with antibiotics. The patient had only one symptom, intense thoracic pain, with no signs of infection except for elevated C reactive protein. The diagnosis was difficult to obtain because of this atypical clinical presentation. The chest computed tomography scan combined with the thoracic pain and the history of fish bone ingestion allowed us to confirm the diagnosis and initiate treatment.