What is Fibrosing Mediastinitis?
Fibrosing Mediastinitis is a pathological condition which is stated to be a uncommon but the most severe form of complication arising from histoplasmosis . It is highly believe that Fibrosing Mediastinitis arises due to abnormal immunologic reply to antigen released by the fungus histoplasma capsulatum which is found in abundance in the soil around us . Fibrosing Mediastinitis can also be caused with a history of histoplasmosis . Such a type of Fibrosing Mediastinitis is term as idiopathic Fibrosing Mediastinitis and is much more obsolete .
Fibrosing Mediastinitis is essentially because of proliferations of collagen , fibrosis tissue , and associated inflammatory cells within the mediastinum . Fibrosing Mediastinitis remains asymptomatic unless the disease has progressed to an advanced stage where there is meaning damage to a muscle or an organ for which the main case is decreased blood stream as a final result of blockage because of a damage watercraft . Scar tissue build up which is very variable being very slow in some individuals and very rapid is some also gives rise to symptom . If there is overweening scar tissue paper build up around a vessel to such an extent that there is decreased rakehell menses to and from the lung then it may result in shape like lung infarct and pleurisy .
What are the Causes of Fibrosing Mediastinitis?
As tell above , Fibrosing Mediastinitis is a uncommon complicatedness of histoplasmosis and develops due to the abnormal resistant chemical reaction to the exposure of the fungus Histoplasma capsulatum . This fungus is plant in the ground in the area around Mississippi and Ohio River valleys . This fungus is present in soil and is fertilized by bird droppings . As before long as the dirt containing the fungus is disturbed , these spore become airborne thus diffuse the infection histoplasmosis which in good turn causes Fibrosing Mediastinitis .
Fibrosing Mediastinitis caused due to other factors and not colligate tohistoplasmosisis call as idiopathic Fibrosing Mediastinitis and has been tie in to aesculapian conditions likeBehcet Disease , Wegener ’s granulomatosis , rheumatic fever , viral infections have due to coxsackie B virus , and even in some case trauma to the mediastinal area . In some cases , Fibrosing Mediastinitis can also pass off due to inflammatory disorders like retroperitoneal fibrosis and sclerosing cholangitis .
What are the Symptoms of Fibrosing Mediastinitis?
An individual with Fibrosing Mediastinitis may have amount in contact with the fungus in childhood itself but the symptom of Fibrosing Mediastinitis present themselves when the mortal is between 20 to 40 age of eld . Some of the symptom of Fibrosing Mediastinitis are :
These symptoms basically go on when one of the main vas like the superior vena cava , the watercraft of the airways , pulmonary arteria get affected due to Fibrosing Mediastinitis . Another symptom due to Fibrosing Mediastinitis is tumefy of the ranking vein cava .
How is Fibrosing Mediastinitis Diagnosed?
The best way to diagnose Fibrosing Mediastinitis whether it is caused due to histoplasmosis or it is idiopathic is by taking a CT scan of the chest . The CT scan of the chest will show unnatural tissue paper in the mediastinum . A perfusion nuclear medicine scan is the best room to nail the location of any boil down pedigree stream around the mediastinal region and also to affirm whether there is enough blood flow to and from the lung in some vitrine , a biopsy is require to rule out any malignancy specially if the unnatural tissue paper does not have calcification evidence on the CT scan . The above tests are sufficient enough to name Fibrosing Mediastinitis .
The problem with Fibrosing Mediastinitis is that the symptom present themselves so deep that the diagnosing is always delayed until there is significant damage already done to the vessels or organs . Fibrosing Mediastinitis can be mistakenly diagnose aspneumonia , COPD , pulmonic or embolism but with the use of CT of the chest the diagnosis of Fibrosing Mediastinitis can now be definitively made .
What is the Treatment for Fibrosing Mediastinitis?
Fibrosing Mediastinitis does not have a successful response to any pharmacologic handling as of yet and hence treatment is based on improve the symptoms . For cases of hemoptysis due to Fibrosing Mediastinitis , a bronchial artery embolization subroutine can be done and is found to be very successful in treating haemoptysis due to Fibrosing Mediastinitis .
Another complication of Fibrosing Mediastinitis is blockage of airways which go and come from the lungs . If vessels of one lung get move then the patient may not have a trouble but when both the lung get affected that is when ramification arise which can be potentially serious . This can be treat with stenting and catheterization . For cases where the superior vena cava gets blocked and result in symptoms like lump of the neck and weapons system , headaches etc . , then stenting or a bypass operating theater may be want for discussion . Fibrosing Mediastinitis caused due to histoplasmosis can also be treated using an antifungal agent called Itraconazole . Studies have shown that antifungal agent are somewhat effective and they do stop the onward motion of Fibrosing Mediastinitis in any way . Localized scar tissue imprint due to Fibrosing Mediastinitis can be polish off surgically but this is a extremely complex procedure and is done rarely .
What is the Prognosis of Fibrosing Mediastinitis?
The overall prognosis for Fibrosing Mediastinitis depends on the extent and severeness of the disease process . Not much study has been done on Idiopathic Fibrosing Mediastinitis but this consideration is not considered as life threatening . medical prognosis of patients with Fibrosing Mediastinitis whose both lung get affect and blocked have a much guarded medical prognosis due to the complexity of the condition but if only one lung is touch on then the prognosis is very astonishingly very safe for patient role suffering from Fibrosing Mediastinitis .
