Work

Mediastinitis caused by Mycoplasma hominis in immunocompetent patients: A case series report and literature review

Year: 2024

Type: article

Abstract: Background Mycoplasma hominis , a commensal organism, is potentially pathogenic; its role in postoperative infections might be underestimated in cardiac surgery. Results We reported two cases of postoperative M. hominis mediastinitis in immunocompetent patients with a DeBakey grade I aortic dissecting aneurysm and reviewed 10 other cases previously described. Among the 10 reviewed cases and our two cases, 11 patients were men (median age, 59 years; median onset of clinical symptoms time, 14.5 d after surgery; and mean peak of temperature, 38.5 ± 0.8 °C). In our reports, two patients underwent sternotomy site reopening and debridement before diagnosis was confirmed. Diagnosis was confirmed by prolonged culture and by performing metagenomic next-generation sequencing directly using the clinical samples. M. hominis was difficult to cover with initial empirical antibiotic therapy; the patient in this study showed complete improvement with long-term antimicrobial therapy. The targeted treatment duration for surviving patients among the reviewed cases ranged from three weeks to 16 months. Conclusions The diagnosis of extragenital M. hominis infections is difficult. Therefore, the role of M. hominis as a cause of postoperative infections during cardiac surgery should be considered. Diagnosis requires molecular techniques to complement culture.

Source: Heliyon

DOI: 10.1016/j.heliyon.2024.e39763