Work

Deep Sternal Wound Infection Caused by Rhizopus Species After Coronary Artery Bypass Graft

Year: 2024

Type: article

Abstract: Deep sternal wound infection is a rare complication of cardiac surgery that is typically caused by skin resident flora, such as species of Staphylococcus and Streptococcus. Infections caused by fungi are less common and are generally caused by Candida species. Regardless of etiology, these infections are associated with significant morbidity and mortality. We present a case of postoperative mediastinitis that occurred following a 5-vessel coronary artery bypass graft and was caused by a filamentous fungus of the Rhizopus genus. The patient was treated with serial debridement, liposomal amphotericin B, and isavuconazonium and was discharged from the hospital in stable condition. Fungal mediastinitis is a rare entity, and clinicians must maintain a high level of suspicion to make the diagnosis. A fungal cause of postoperative mediastinitis should be considered in patients with negative bacterial cultures, uncontrolled diabetes, or current immunosuppression or those who present weeks after surgery with a subacute onset of symptoms.

Source: Open Forum Infectious Diseases

DOI: 10.1093/ofid/ofae302

Authors: Cody A Cunningham, Thomas E Grys, Francis X Downey, Christopher F Saling, Robert Orenstein, Janis E Blair

Institutions: Mayo Clinic, Mayo Clinic in Arizona, Mayo Clinic Hospital

Language: English

Topic: Antifungal resistance and susceptibility

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,256