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.
Dajer-FadelWLIbarra-PerezCBorrego-BorregoRFlores-CalderonO. Thoracic necrotizing fasciitis due to snake ointment that progressed to a mediastinitis. Interact Cardiovasc Thorac Surg2012; 14: 94–95.
2.
Dajer-FadelWLBorrego-BorregoRFlores-CalderonOIbarra-PerezC. Descending necrotizing mediastinitis and thoracic cellulitis due to varicella. Asian Cardiovasc Thorac Ann2012; 20: 83–85.
3.
PollackMS. Staphylococcal mediastinitis due to sternoclavicular pyarthrosis: CT appearance. J Comput Assist Tomogr1990; 14: 924–927.
4.
ZehrKJHeitmillerRFYangSC. Split pectoralis major muscle flap reconstruction after clavicular-manubrial resection. Ann Thorac Surg1999; 67: 1507–1508.
5.
SongHKGuyTSKaiserLRShragerJB. Current presentation and optimal surgical management of sternoclavicular joint infections. Ann Thorac Surg2002; 73: 427–431.
