title: Ascending necrotizing mediastinitis secondary to emphysematous pyelonephritis.
abstract: Mediastinal infections usually originate from postoperative complications or in a descending manner from a cervical infectious process; few reports have emerged describing an ascending trajectory. A 56-year-old woman with a Huang class 1 left emphysematous pyelonephritis was referred due to a progression of an ascending necrotizing mediastinitis. A left posterolateral thoracotomy was performed, drainage and thorough lavage were carried out with a successful outcome. We believe this is the first reported case of ascending necrotizing mediastinitis secondary to an emphysematous renal infection.
authors.affiliation: Department of Cardiothoracic Surgery, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico wadafa@hotmail.com.
authors.forename: Walid Leonardo
authors.initials: WL
authors.lastname: Dajer-Fadel
authors.affiliation: Department of Cardiothoracic Surgery, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico.
authors.forename: Martha
authors.initials: M
authors.lastname: Pichardo-González
authors.affiliation: Department of Cardiothoracic Surgery, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico.
authors.forename: Sandra
authors.initials: S
authors.lastname: Estrada-Ramos
authors.affiliation: Department of Cardiothoracic Surgery, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico.
authors.forename: Damián
authors.initials: D
authors.lastname: Palafox
authors.affiliation: Department of Cardiothoracic Surgery, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico.
authors.forename: Francisco Pascual
authors.initials: FP
authors.lastname: Navarro-Reynoso
authors.affiliation: Department of Cardiothoracic Surgery, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico.
authors.forename: Rubén
authors.initials: R
authors.lastname: Argüero-Sánchez
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D004322:Drainage; D004646:Emphysema / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D004927:Escherichia coli Infections / Q000150:complications / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008480:Mediastinitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D008875:Middle Aged; D009336:Necrosis; D011704:Pyelonephritis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents
keywords: Emphysema; mediastinitis; mediastinum; pyelonephritis; thoracic surgical procedures