Diagnosing poststernotomy mediastinitis in the ED

The speed and accuracy of diagnosing PSM have improved with recent advances in imaging and laboratory methodologies. In the symptomatic patient with a closed sternotomy wound or scar, with either fever (> 38°C) or sternal instability, together with well-described signs on contrast-enhanced computed tomography, in whom other life-threatening causes of chest pain have been excluded, the diagnosis of PSM can be made without awaiting the outcome of microbiological confirmation. Nevertheless, there still remain significant research opportunities for clinicians and scientists to improve the early diagnostic accuracy of PSM.