REVIEW article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1653443
Mediastinal Infections: Diagnostic and Therapeutic Advances 1 from Traditional Surgery to Novel Minimally Invasive 2 Techniques
Provisionally accepted
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Mediastinal infections present significant diagnostic and therapeutic 11 challenges, contributing to highly variable mortality. Diagnostic 12 dilemmas arise from complex anatomy and radiographic similarities 13 to malignancies. Endobronchial Ultrasound-guided Transbronchial 14 Needle Aspiration (EBUS-TBNA) and cultures are constrained by 15 small samples, architectural distortion, low sensitivity, and slow 16 results in special circumstances. Therapeutic obstacles include 17 antibiotic resistance, poor antimicrobial penetration due to altered 18 vascularity, and high surgical morbidity. Endobronchial 19 ultrasound-guided transbronchial mediastinal cryobiopsy 20 (EBUS-TMC) provides larger histologically preserved specimens; 21 2 metagenomic next-generation sequencing (mNGS) achieves rapid 22 sensitive pathogen detection; advanced imaging (Dual Energy 23 Computed Tomography, DECT; Positron Emission 24 Tomography/Computed Tomography, PET/CT) enhances lesion 25 differentiation and intervention planning; while minimally invasive 26 drainage, nanocarrier-based targeted antimicrobial delivery, and 27 reconstructive techniques collectively reduce complications and 28 improve therapeutic efficacy. Multidisciplinary integration of these 29 innovations is advancing precision medicine approaches.
Keywords: mediastinal infections, Diagnostic challenges, Therapeutic challenges, Mortality, precision medicine
Received: 25 Jun 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 Xu, Liang, Huang, Wang, Liang, Jiang, Huang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yansong Xu, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
Junting Liu, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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