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Modified Clagett Procedure Is Effective for Methicillin-Resistant Staphylococcus aureus Postpneumonectomy Empyema: A
Stefan Welter1, Sandra Kampe2, Jan Dziobaka3
1Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West-German Lung Center, University Hospital, University of Duisburg-Essen, Germany.
World Journal of Oncology
|November 18, 2017
Summary
Postpneumonectomy empyema (PPE) caused by methicillin-resistant Staphylococcus aureus (MRSA) is difficult to treat. This case highlights a successful treatment using surgical debridement, vancomycin packing, and latissimus myoplasty.
Area of Science:
- Infectious Diseases
- Thoracic Surgery
- Surgical Innovation
Background:
- Postpneumonectomy empyema (PPE) presents significant therapeutic challenges.
- Methicillin-resistant Staphylococcus aureus (MRSA) infections complicate PPE due to potent virulence factors and immune evasion mechanisms.
Observation:
- A patient with postpneumonectomy empyema caused by MRSA was treated.
Findings:
- The successful treatment involved accelerated repeated surgical debridement.
- Vancomycin gauze packing was utilized to combat the MRSA infection.
- Final obliteration of the empyema space was achieved with latissimus myoplasty and vancomycin solution.
Implications:
- This multimodal approach offers a viable strategy for managing complex MRSA PPE.
- Latissimus myoplasty can be an effective method for obliterating postpneumonectomy spaces.
- Aggressive surgical intervention combined with targeted antibiotic delivery is crucial for favorable outcomes in challenging empyema cases.
