title: Descending necrotizing mediastinitis and sternoclavicular joint osteomyelitis.
abstract: Descending necrotizing mediastinitis is usually associated with cervical or odontogenic infections. We describe a patient with blunt trauma to the chest 2 years earlier, and a slowly developing chest wall hematoma 18 months prior to admission, complicated by chronic sternoclavicular joint osteomyelitis, eventually leading to descending mediastinitis. Thoracotomy with drainage of the mediastinal spaces and multiple procedures for the sternoclavicular joint infection were successful. The rarity of this association and undefined optimal management prompted this report.
authors.affiliation: Department of Cardiothoracic Surgery, General Hospital of Mexico, Mexico City, Mexico.
authors.forename: Walid L
authors.initials: WL
authors.lastname: Dajer-Fadel
authors.forename: Carlos
authors.initials: C
authors.lastname: Ibarra-Pérez
authors.forename: Rafael
authors.initials: R
authors.lastname: Borrego-Borrego
authors.forename: Francisco P
authors.initials: FP
authors.lastname: Navarro-Reynoso
authors.forename: Rubén
authors.initials: R
authors.lastname: Argüero-Sánchez
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement; D004322:Drainage; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008480:Mediastinitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D008875:Middle Aged; D009336:Necrosis; D010019:Osteomyelitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013247:Sternoclavicular Joint / Q000382:microbiology*; D007507:Therapeutic Irrigation; D013908:Thoracotomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Mediastinitis; nonpenetrating; osteomyelitis; staphylococcal infections; sternoclavicular joint; wounds