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A fatal fungus.

Ishtiaq M Ahmed1, Ajay Gupta, Kate Gould

  • 1Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle Upon Tyne, England, United Kingdom.

The Annals of Thoracic Surgery
|July 26, 2005
PubMed
Summary
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A rare mediastinal infection caused by Candida famata occurred in a patient 4 years after coronary artery bypass graft surgery. Aggressive antifungal therapy was initiated for this unique fungal mediastinitis case.

Area of Science:

  • Medical Mycology
  • Cardiovascular Surgery
  • Infectious Diseases

Background:

  • Coronary artery bypass graft (CABG) surgery is a common cardiovascular procedure.
  • Mediastinal infections are serious complications following cardiac surgery.
  • Fungal infections of the mediastinum are rare but carry high morbidity and mortality.

Observation:

  • A 66-year-old male presented with prodromal symptoms and pre-sternal swelling 4 years post-CABG.
  • Computed tomography revealed a retrosternal mass with extension to an anterior collection near the right ventricle.
  • Operative specimens yielded Candida famata, a yeast not commonly associated with invasive disease.

Findings:

  • The patient was diagnosed with a mediastinal fungal infection.
  • Candida famata was identified as the causative agent of the mediastinal mass and collection.

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  • The infection presented unusually late, 4 years after the initial cardiac surgery.

    • Implications:

    • This case highlights the potential for late-onset, rare fungal infections post-cardiac surgery.
    • It underscores the importance of considering unusual pathogens like Candida famata in complex post-operative infections.
    • Effective aggressive antifungal therapy is crucial for managing such rare mediastinal mycoses.