title: Descending necrotizing mediastinitis with sternocostoclavicular osteomyelitis and partial thoracic empyema: report of a case.
abstract: We present herein the case of a 50-year-old woman in whom descending necrotizing mediastinitis originating from an anterior neck abscess spread to the left upper bony thorax, resulting in osteomyelitis of the left sternocostoclavicular articulation and left partial thoracic empyema. Transcervical mediastinal irrigation and drainage was performed with aggressive antibiotic therapy, followed by resection of the left sternocostoclavicular joint and debridement of the anterior mediastinum. The patient had an uneventful postoperative course, and her left arm and shoulder mobility was well preserved.
authors.affiliation: Department of Thoracic Surgery, Tenri Hospital, Nara, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sonobe
authors.forename: M
authors.initials: M
authors.lastname: Miyazaki
authors.forename: M
authors.initials: M
authors.lastname: Nakagawa
authors.forename: N
authors.initials: N
authors.lastname: Ikegami
authors.forename: Y
authors.initials: Y
authors.lastname: Suzumura
authors.forename: M
authors.initials: M
authors.lastname: Nagasawa
authors.forename: T
authors.initials: T
authors.lastname: Shindo
mesh_terms: D000038:Abscess / Q000150:complications* / Q000628:therapy; D000900:Anti-Bacterial Agents; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D004322:Drainage / Q000379:methods; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D016724:Empyema, Pleural / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008480:Mediastinitis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D009333:Neck; D009336:Necrosis; D010019:Osteomyelitis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D011877:Radionuclide Imaging; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000628:therapy*; D013247:Sternoclavicular Joint / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents