• BMJ case reports · Jan 2009

    Indolent form of mediastinitis caused by oesophageal perforation from fish bone ingestion.

    • Alessandro W Mariani, Paulo Manuel Pêgo-Fernandes, Marcos Naoyoki Samano, Euclides Furtado de Albuquerque Cavalcanti, Juan José Cevasco, and Maurício Daniel Gattaz.
    • Heart Institute, Thoracic Surgery Department, Av Dr Eneas Carvalho de Aguiar, 44, São Paulo, 05406000, Brazil.
    • BMJ Case Rep. 2009 Jan 1;2009.

    AbstractMediastinitis 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.

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