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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Pearse HE (1938) Mediastinitis following cervical suppuration. Ann Surg 108:588–611
Estrera AS, Landay MJ, Grisham JM, Sinn DP, Platt MR (1983) Descending necrotizing mediastinitis. Surg Gynecol Obstet 157:545–552
Beck HJ, Salassa JR, McCaffrey TV, Hermans PE (1984) Lifethreatening soft-tissue infections of the neck. Laryngoscope 94:354–362
Marty-Ane CH, Alauzen M, Alric P, Serres-Cousine O, Mary H (1994) Deseending necrotizing mediastinitis. Advantage of mediastinal drainage with thoracotomy. J Thorac Cardiovasc Surg 107:55–61
Wheatley MJ, Stirling MC, Kirsh MM, Gago O, Orringer MB (1990) Descending necrotizing mediastinitis: transcervical drainage is not enough. Ann Thorac Surg 49:780–784
Corsten MJ, Shamji FM, Odell PF, Frederico JA, Laframboise GG, Reid KR, Vallieres E, Matzinger F (1997) Optimal treatment of descending necrotising mediastinitis. Thorax 52:702–708
Kiernan PD, Hernandez A, Byrne WD, Bloom R, Dicicco B, Hetrick V, Graling P, Vaughan B (1998) Descending cervical mediastinitis. Ann Thorac Surg 65:1483–1488
Endicott JN, Nelson RJ, Saraceno CA (1982) Dragnosis and management decisions in infections of the deep neck fascial spaces of the head and neck utilizing computerized tomography. Laryngoscope 92:630–633
Ris HB, Banic A, Furrer M, Caversaccio M, Cerny A, Zbaren P (1996) Descending necrotizing mediastinitis: surgical treatment via clamshell approach. Ann Thorac Surg 62:1650–1654
Izumoto H, Kodama K, Okada O, Kamata J, Kawazoe K (1996) Successful utilization of the median sternotomy approach in the management of descending necrotizing mediastinitis: report of a case. Surg Today 26:286–288
Levine TM, Wurster CF, Krespi YP (1986) Mediastinitis occurring as a complication of odontogenic infections. Laryngoscope 96:747–750
Tabib W, Banalec L, Rehel P, Franco D, Cottin P (1996) Primary acute osteomyelitis of the stermum with anterior mediastinitis (in French with English abstract). J Chir 133:20–22
Kelly CA, Chetty MN, (1985) Primary sternal osteomyelitis. Thorax 40:872–873
Jara FM, Yap A, Toledo-Pereyra LH, Magilligan DJ (1979) The role of surgery in primary osteomyelitis of the chest wall. J Thorac Cardiovasc Surg 77:147–150
Acus RW III, Bell RH, Fisher DL (1995) Proximal clavicle excision: an analysis of results. J Shoulder Elbow Surg 4:182–187
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sonobe, M., Miyazaki, M., Nakagawa, M. et al. Descending necrotizing mediastinitis with sternocostoclavicular osteomyelitis and partial thoracic empyema: Report of a case. Surg Today 29, 1287–1289 (1999). https://doi.org/10.1007/BF02482226
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02482226