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Related Experiment Videos

Candida mediastinitis after a cardiac operation.

D D Glower1, J M Douglas, J W Gaynor

  • 1Department of Surgery, Durham Veterans Administration Hospital, North Carolina.

The Annals of Thoracic Surgery
|January 1, 1990
PubMed
Summary

Candida mediastinitis, a rare fungal infection, has high mortality. Aggressive surgical intervention including mediastinal drainage and vascularized flap closure significantly improves survival rates and reduces chronic morbidity.

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Area of Science:

  • Infectious Diseases
  • Surgical Critical Care
  • Mycology

Background:

  • Candida mediastinitis is a rare but severe complication, predominantly occurring post-cardiac surgery.
  • The condition is associated with high mortality rates, particularly in patients without a history of cardiac procedures.

Observation:

  • A review of 39 cases revealed that 67% of Candida mediastinitis occurred after cardiac operations.
  • Mortality was 55% in the postoperative setting and 92% in non-cardiac surgery patients.
  • No patient survived without surgical mediastinal drainage.

Findings:

  • Survival rates improved to 85% among patients who underwent operative mediastinal drainage.
  • Chronic wound infections occurred in survivors treated without muscle flap closure.

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  • All patients closed with vascularized flaps achieved ultimate healing.

    • Implications:

    • Aggressive surgical management is crucial for Candida mediastinitis.
    • Key interventions include mediastinal drainage, sternal debridement, and early wound closure with vascularized flaps.
    • These strategies are essential to minimize high morbidity and mortality associated with this infection.