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Radiologic Manifestations of Mycobacterium chimaera Infection After Open Heart Surgery.

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Radiologic imaging, including CT and PET/CT, helps identify surgical site and disseminated Mycobacterium chimaera (MC) infections after open heart surgery. Early detection is crucial due to MC

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Area of Science:

  • Radiology
  • Infectious Diseases
  • Cardiothoracic Surgery

Background:

  • Mycobacterium chimaera (MC) infection is a rare but serious complication following open heart surgery.
  • The indolent nature and subtle clinical presentation of MC infection pose diagnostic challenges.

Purpose of the Study:

  • To identify and detail the radiologic manifestations of surgical site and disseminated MC infection.
  • To aid in the early identification and diagnosis of MC infection through imaging.

Main Methods:

  • Retrospective cohort study of patients (>18 years) with open heart surgery and MC diagnosis.
  • Review of CT, PET/CT, and MRI examinations by experienced radiologists.
  • Consensus reads to determine characteristic imaging findings of MC infection.

Main Results:

  • Twenty-five patients were included; localized surgical site infection was more common than disseminated disease.
  • CT findings included peristernal thickening, sinus tracts, fluid collections, and sternal osteolysis.
  • PET/CT showed hypermetabolic activity at infection sites; disseminated disease included hepatosplenomegaly, lymphadenopathy, CNS involvement, discitis, and abscesses.

Conclusions:

  • Imaging is vital for suspecting MC infection post-open heart surgery.
  • Radiologists need a high index of suspicion for subtle, indolent changes.
  • PET/CT is valuable for differentiating active infection from sterile postoperative changes and guiding debridement.