[Fulminant mediastinitis from Streptococcus pneumoniae following cardiac surgery]

A 62-year-old patient was scheduled for coronary artery bypass surgery because of tritroncular coronary artery disease. The early postoperative period was uncomplicated until the 10th postoperative day when purulent fluid appeared from the sternal wound. Cultures of blood, wound and mediastinal tissues yielded Streptococcus pneumoniae with decreased susceptibility to penicillin G. Despite prompt surgical debridement and appropriate antibiotics, a septic shock with multiorgan failure occurred and the patient died on the 19th postoperative day. Although Streptococcus pneumoniae is uncommonly implicated in postoperative mediatinitis, it frequently leads to multiple organ failure and death.