Cain Caitlin J, Ahmad Huzaifa, Molina Ezequiel J
Georgetown University School of Medicine, Washington, District of Columbia.
Division of Internal Medicine, MedStar Washington Hospital Center, Washington, District of Columbia.
J Card Surg. 2020 Nov;35(11):3191-3194. doi: 10.1111/jocs.14928. Epub 2020 Aug 2.
Mycobacterium chimaera can cause disseminated infection following cardiac surgery with cardiopulmonary bypass and contaminated heater-cooler devices. We discuss a 41-year-old man with a disseminated M. chimaera infection following surgery for a type A aortic dissection. His presentation included cachexia and dorsalgia with a work-up revealing vertebral osteomyelitis with an epidural abscess, bone marrow, and pulmonary infiltration, and fluid collection around his aortic graft. He received 1 month of antibiotics before the explantation of infected foreign material, mediastinal debridement, and aortic reconstruction. Complications included septic shock, respiratory and renal failure, mediastinitis, and four distal aortic anastomotic dehiscences from friable tissue and persistent infection.
嵌合体分枝杆菌可在体外循环心脏手术及受污染的热交换器装置使用后引起播散性感染。我们讨论一名41岁男性，其在接受A型主动脉夹层手术后发生了嵌合体分枝杆菌播散性感染。他的表现包括恶病质和背痛，检查发现椎体骨髓炎伴硬膜外脓肿、骨髓及肺部浸润，以及主动脉移植物周围积液。在取出感染的异物、进行纵隔清创和主动脉重建之前，他接受了1个月的抗生素治疗。并发症包括感染性休克、呼吸和肾衰竭、纵隔炎，以及因组织脆弱和持续感染导致的四处远端主动脉吻合口裂开。
