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Anaerobic mediastinitis complicating median sternotomy
The American Journal of the Medical Sciences
|September 1, 1985
Summary
Two cases of Bacteroides mediastinitis after sternotomy highlight this rare infection. Prompt surgical intervention and antibiotics led to recovery, suggesting it may be underdiagnosed.
Area of Science:
- Infectious Diseases
- Surgical Infections
- Microbiology
Background:
- Median sternotomy is a common surgical approach for cardiac procedures.
- Mediastinitis, an infection of the mediastinum, can be a serious complication.
- Bacteroides species are anaerobic bacteria that can cause opportunistic infections.
Observation:
- Two patients developed mediastinitis and bacteremia caused by Bacteroides species post-median sternotomy.
- Clinical presentation included purulent sternal drainage and systemic toxicity.
- Diagnosis was confirmed by clinical signs and likely microbiological evaluation.
Findings:
- Both patients were successfully treated with surgical reexploration and appropriate antibiotic therapy.
- This report adds two cases to the single previously reported instance of anaerobic mediastinitis after sternotomy.
- The findings suggest that Bacteroides mediastinitis following median sternotomy may occur more frequently than previously recognized.
Implications:
- Clinicians should consider Bacteroides species in the differential diagnosis of mediastinitis after sternotomy.
- Early recognition and aggressive management, including surgical drainage and antibiotics, are crucial for favorable outcomes.
- Further surveillance may be warranted to determine the true incidence of this potentially underreported infection.