Postpneumonectomy space infection eight years after mediastinal repositioning procedure

Area of Science:

• Thoracic Surgery
• Surgical Complications
• Infectious Diseases

Background:

• Postpneumonectomy syndrome can necessitate mediastinal repositioning using prosthetic implants.
• Chronic infection of these implants is a rare but serious complication.

Purpose of the Study:

• To report the first known case of chronic infection of a repositioned mediastinum in postpneumonectomy syndrome.
• To describe the successful management of empyema necessitans secondary to infected prostheses.

Main Methods:

• Presentation of a case involving a patient with empyema necessitans 8 years post-prosthetic implantation for postpneumonectomy syndrome.
• Surgical intervention included chest wall sinus excision, re-do thoracotomy, infected prosthesis removal, and intrapleural irrigation.

Main Results:

• Successful resolution of empyema necessitans and infection.
• Patient remained clinically well at 1-year follow-up with a centralized mediastinum and no recurrence of infection.
• No evidence of mediastinitis was found.

Conclusions:

• Chronic infection of repositioned mediastinal prostheses can occur in postpneumonectomy syndrome.
• Aggressive surgical management, including prosthesis removal and irrigation, can effectively treat this complication.
• This case highlights the importance of vigilance for late-onset infections in patients with prosthetic materials in the postpneumonectomy space.