Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Mediastinitis after Central Venous Catheterization

중심정맥관 삽입후 발생한 종격동염-1례 보고

  • Keum, Dong Yoon (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyemyung University) ;
  • Park, Nam Hee (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyemyung University) ;
  • Lee, Kee Tae (Department of Internal Medicine, School of Medicine, Kyemyung University)
  • 금동윤 (계명대학교 동산의료원 흉부외과학교실) ;
  • 박남희 (계명대학교 동산의료원 흉부외과학교실) ;
  • 이기태 (계명대학교 동산의료원 내과학교실)
  • Received : 2004.10.11
  • Accepted : 2004.10.28
  • Published : 2005.01.30
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Abstract

We report here on an uncommon case of mediastinitis that occurred after central venous catheterization. A patient with colon and jejunal cancer complained high fever, right shoulder pain, chest pain, and limited motion of the affected shoulder just 6 days after central venous catheterization. Bacterial culture of the blood, shoulder abscess, and catheter puncture site revealed methicillin-resistent staphylococcus aureus. Right upper mediastinal widening on chest film also suggested mediatinitis. Mediastiotomy and pus drainage was performed along with adequate antibiotics therapy. In this case, it seems that initially formed bacteria from the puncture site migrated to the mediastinum through the tissue plane to start the mediastinitis. Careful dressing of puncture site and correct handling of catheter is important to prevent this serious complication.

중심정맥관 삽입술 시행후 6일이 경과한 65세 여자환자로 고열과 우측 견갑통 및 흉통, 호흡곤란을 호소하여 단순 흉부사진상 상종격동의 확장소견, 중심정맥관 삽입부 및 견갑부 농양, 혈액 배양검사상 메티실린 저항성 포도상구균이 검출되어 중심정맥관에 의해 드물게 발생할 수 있는 종격동염으로 진단후 종격동절개를 통한 배농, 적절한 항생제 사용 등으로 환자는 회복되었다.

Keywords

References

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