Features of purulent mediastinitis in patients with comorbid secondary immunodeficiency

Abstract

Objective. To characterize the immune response in patients with purulent mediastinitis against the background of secondary immunodeficiency and to justify targeted surgical treatment of purulent-septic complications. Materials and methods. The results of diagnosis and treatment of purulent mediastinitis in 67 patients were analyzed. The patients were divided into two groups: the main group consisted of 35 patients in whom the onset of purulent-septic complications was accompanied by suppression of the immune response, and the control group – 32 patients in whom no immune disorders were recorded during the treatment stages. Results. The inductive phase of the immune response in patients with purulent mediastinitis against the background of secondary immunodeficiency was characterized by the development of a slow adaptive immune response, while the effector phase was characterized by a slow and short-lived increase in signs of a systemic inflammatory response, an increase in serum immunoglobulin levels, and a moderate increase in neutrophil phagocytic activity. Conclusions. Secondary immunodeficiency in purulent mediastinitis, which determines the characteristics of purulent-septic complications and the tactics of therapeutic measures, occurs in 52% of patients.