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Fallibility of intra-operative gram stain in the diagnosis of vascular infection
Angiology
|October 1, 1982
Abstract:
Three cases of arterial-graft infection are presented. In all cases the gram stain obtained at surgery demonstrated white blood cells but no bacteria. Cultures obtained at operation subsequently grew Pseudomonas aeruginosa in two patients and Bacteroides fragilis in one patient. Failure to recognize the fallibility of the gram stain in the diagnosis of vascular infection may result in incorrect management decisions.
Insights
The gram stain test may miss bacteria in vascular graft infections, leading to incorrect treatment. Prompt bacterial cultures are crucial for accurate diagnosis and management of arterial-graft infections.
Area of Science:
- Infectious Diseases
- Vascular Surgery
- Microbiology
Background:
- Arterial-graft infections are serious complications following vascular surgery.
- Accurate and timely diagnosis is critical for effective patient management and outcomes.
Observation:
- Gram stain analysis of surgical specimens revealed white blood cells but no bacteria in three arterial-graft infection cases.
- Subsequent intraoperative cultures identified bacterial pathogens in all cases.
Findings:
- Pseudomonas aeruginosa was cultured in two patients.
- Bacteroides fragilis was identified in one patient.
- The gram stain's sensitivity in diagnosing vascular infections can be limited.
Implications:
- Relying solely on gram stain can lead to misdiagnosis and delayed treatment of vascular graft infections.
- Microbiological cultures are essential for identifying causative agents in suspected arterial-graft infections.
- Clinical decisions for vascular infections should integrate gram stain findings with definitive culture results.