Mediastinitis most often occurs after cardiac surgery. Diagnosis of mediastinitis must be based on one of the four following criteria.
Criteria 1: organism isolated from culture of mediastinal tissue or fluid obtained by needle aspiration or during surgery
Criteria 2 - one of the following:
(1) evidence of mediastinitis seen during surgery
(2) evidence of mediastinitis seen on histopathologic examination
Criteria 3 - all of the following:
(1) patient age > 12 months
(2) one or more of the following symptoms:
(2a) fever (> 38° C)
(2b) chest pain
(2c) chest instability
(3) one or more of the following:
(3a) purulent drainage from the mediastinal area
(3b) organism isolated from blood culture
(3c) organism isolated from drainage from mediastinal area
(3d) mediastinal widening on x-ray examination
Criteria 4 - all of the following:
(1) patient age <= 12 months
(2) one or more of the following symptoms:
(2a) fever (> 38° C) or hypothermia (< 37°C)
(2b) bradycardia
(2c) chest instability
(2d) apnea
(3) one or more of the following:
(3a) purulent drainage from the mediastinal area
(3b) organism isolated from blood culture
(3c) organism isolated from drainage from mediastinal area
(3d) mediastinal widening on x-ray examination
Specialty: Infectious Diseases, Cardiology, Emergency Medicine
ICD-10: ,