Abstract
Abstract:A 43-year-old lady with type 2 diabetes mellitus and bronchial asthma presented with varicella zoster infection, dyspnea, and neck fullness. An urgent computed tomography scan revealed a mediastinal abscess with superior vena cava thrombus. Blood, mediastinal pus, and swab from a vesiculopustule on the neck cultured group A beta hemolytic Streptococcus. She recovered with a combination of broad spectrum antimicrobials, antivirals, and surgical drainage. This case illustrates the rare occurrence of mediastinal abscess and acute superior vena cava obstruction caused by group A beta hemolytic Streptococcus complicating adult varicella zoster.
This content is limited to qualifying members.
If you have an existing account please login now to access this article or view purchase options.
Create a free account, then purchase this article to download or access it online for 24 hours.
Create a free account, then purchase a subscription to get complete access to all articles for a full year.
References
References1. Lee BW. Review of varicella zoster seroepidemiology in India and Southeast Asia. Trop Med Int Health 1998;3:886–890.LeeBWReview of varicella zoster seroepidemiology in India and Southeast Asia.Trop Med Int Health19983886-8902. Gnann JW Jr. Varicella-zoster virus: atypical presentations and unusual complications. J Infect Dis 2002;186:S91–S98.GnannJWJrVaricella-zoster virus: atypical presentations and unusual complications.J Infect Dis2002186S91-S983. Laupland KB, Davies HD, Low DE, et al. Invasive group A streptococcal disease in children and association with varicella-zoster virus infection. Ontario Group A Streptococcal Study Group. Pediatrics 2000;105:E60.LauplandKB]]DaviesHD]]LowDE&etal;Invasive group A streptococcal disease in children and association with varicella-zoster virus infection. Ontario Group A Streptococcal Study Group.Pediatrics2000105E604. Conway JH, Nyquist AC, Goldson E. Posterior mediastinal abscess caused by invasive group A streptococcus infection. Pediatr Infect Dis J 1996;15:547–549.ConwayJH]]NyquistAC]]GoldsonEPosterior mediastinal abscess caused by invasive group A streptococcus infection.Pediatr Infect Dis J199615547-5495. Makeieff M, Gresillon N, Berthet JP, et al. Management of descending necrotizing mediastinitis. Laryngoscope 2004;114:772–775.MakeieffM]]GresillonN]]BerthetJP&etal;Management of descending necrotizing mediastinitis.Laryngoscope2004114772-7756. Stone HH, Martin JD Jr. Synergistic necrotizing cellulitis. Ann Surg 1972;175:702–711.StoneHH]]MartinJDJrSynergistic necrotizing cellulitis.Ann Surg1972175702-7117. Cheng S. Superior vena cava syndrome: a contemporary review of a historic disease. Cardiol Rev 2009;17:16–23.ChengSSuperior vena cava syndrome: a contemporary review of a historic disease.Cardiol Rev20091716-238. Pinto A, Scaglione M, Scuderi MG, et al. Infections of the neck leading to descending necrotizing mediastinitis: role of multi-detector row computed tomography. Eur J Radiol 2008;65:389–394.PintoA]]ScaglioneM]]ScuderiMG&etal;Infections of the neck leading to descending necrotizing mediastinitis: role of multi-detector row computed tomography.Eur J Radiol200865389-3949. Moriwaki Y, Sugiyama M, Matsuda G, et al. Approach for drainage of descending necrotizing mediastinitis on the basis of the extending progression from deep neck infection to mediastinitis. J Trauma 2002;53:112–116.MoriwakiY]]SugiyamaM]]MatsudaG&etal;Approach for drainage of descending necrotizing mediastinitis on the basis of the extending progression from deep neck infection to mediastinitis.J Trauma200253112-11610. Sancho LM, Minamoto H, Fernandez A, et al. Descending necrotizing mediastinitis: a retrospective surgical experience. Eur J Cardiothorac Surg 1999;16:200–205.SanchoLM]]MinamotoH]]FernandezA&etal;Descending necrotizing mediastinitis: a retrospective surgical experience.Eur J Cardiothorac Surg199916200-20511. Singhal P, Kejriwal N, Lin Z, et al. Optimal surgical management of descending necrotizing mediastinitis: our experience and review of literature. Heart Lung Circ 2008;17:124–128.SinghalP]]KejriwalN]]LinZ&etal;Optimal surgical management of descending necrotizing mediastinitis: our experience and review of literature.Heart Lung Circ200817124-12812. Isowa N, Yamada T, Kijima T, et al. Successful thoracoscopic debridement of descending necrotizing mediastinitis. Ann Thorac Surg 2004;77:1834–1837.IsowaN]]YamadaT]]KijimaT&etal;Successful thoracoscopic debridement of descending necrotizing mediastinitis.Ann Thorac Surg2004771834-183713. Macarrón CP, Palomino AP, Matute de Cárdenas JA, et al. Descending necrotizing mediastinitis in a child with chickenpox. J Thorac Cardiovasc Surg 2007;133:271–272.MacarrónCP]]PalominoAP]]Matute de CárdenasJA&etal;Descending necrotizing mediastinitis in a child with chickenpox.J Thorac Cardiovasc Surg2007133271-272