Acute mediastinitis secondary to leakage of parenteral nutrition from a migrated central venous catheter in a patient undergoing autologous bone marrow transplant.

ABSTRACT

We describe an unusual case of pyrexia of unknown origin in a patient undergoing autologous bone marrow transplantation for metastatic breast cancer. The fever was due to extravasation of lipid-containing hyperalimentation fluid from a migrated central venous catheter into the mediastinum, resulting in mediastinitis and pleurisy. The fever persisted despite broad-spectrum antibiotics and amphotericin B, and finally responded to steroids.