Rosenbaum G S, Klein N C, Cunha B A
Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501.
Heart Lung. 1990 Jul;19(4):371-2.
The clinician should suspect mediastinitis in patients after sternotomy who have unexplained fever or leukocytosis, sternal wound tenderness, or atypical chest or neck discomfort 2 to 3 weeks following surgery. Mediastinitis should be considered if any of these features are present. The diagnosis should be aggressively pursued by mediastinal aspiration via the suprasternal notch. Early empiric treatment with an antibiotic(s) with antistaphylococcal and gram-negative coverage is critical to survival.
临床医生应怀疑胸骨切开术后患者出现不明原因发热或白细胞增多、胸骨伤口压痛，或术后2至3周出现非典型胸痛或颈部不适时可能发生纵隔炎。若出现上述任何特征，均应考虑纵隔炎。应通过胸骨上切迹积极进行纵隔穿刺抽吸以明确诊断。早期经验性使用覆盖抗葡萄球菌和革兰氏阴性菌的抗生素治疗对患者生存至关重要。
