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.
Subject(s)
Escherichia coli Infections/microbiology , Mediastinitis/microbiology , Osteomyelitis/microbiology , Staphylococcal Infections/microbiology , Sternoclavicular Joint/microbiology , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Debridement , Drainage , Escherichia coli Infections/diagnosis , Escherichia coli Infections/therapy , Female , Humans , Mediastinitis/diagnosis , Mediastinitis/therapy , Middle Aged , Necrosis , Osteomyelitis/diagnosis , Osteomyelitis/therapy , Risk Factors , Staphylococcal Infections/diagnosis , Staphylococcal Infections/therapy , Therapeutic Irrigation , Thoracotomy , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Reportamos nueve pacientes con artritis séptica esternoclavicular (ASEC), dos de los cuales fueron adictos a drogas endovenosas, pero en ningún caso a heroína. La edad promedio fue de 34.5 años. El sexo más frecuente fue el masculino. En seis pacientes se aisló el microorganismo causal, siendo el más frecuente aislado el Stafilococo aureus. Ocho pacientes fueron tratados y tuvieron excelente respuesta