K-L Lo Carson, Wilson Evan W
Division of Infectious Diseases, McMaster University, Hamilton, Ontario, Canada.
Division of Infectious Diseases, Queen's University, Kingston, Ontario, Canada.
J Assoc Med Microbiol Infect Dis Can. 2022 Sep 27;7(3):269-278. doi: 10.3138/jammi-2021-0032. eCollection 2022 Sep.
Sternal osteomyelitis caused by spp is uncommon in cardiac surgery patients requiring sternotomy.
We report a 77-year-old male with a history of poorly controlled diabetes who was diagnosed with sternal osteomyelitis, three months following an uneventful coronary artery bypass surgery. He underwent multiple debridement surgeries and was treated with voriconazole. Despite a complicated post-operative course, the patient responded well to voriconazole with clinical and biochemical evidence of remission. Unfortunately, he died of an unrelated cause due to decompensated heart failure.
Though uncommon, sternal osteomyelitis should be considered in the differential diagnosis of immunocompetent patients with post-operative sternal wound infections and negative bacterial tissue cultures. Management should include a combination of medical and surgical therapy.
在需要进行胸骨切开术的心脏手术患者中，由[具体菌种]引起的胸骨骨髓炎并不常见。
我们报告一名77岁男性，有糖尿病控制不佳病史，在冠状动脉搭桥手术顺利进行三个月后被诊断为胸骨骨髓炎。他接受了多次清创手术，并接受伏立康唑治疗。尽管术后病程复杂，但患者对伏立康唑反应良好，有临床和生化缓解证据。不幸的是，他因失代偿性心力衰竭死于无关原因。
虽然不常见，但在免疫功能正常的术后胸骨伤口感染且细菌组织培养阴性的患者鉴别诊断中应考虑胸骨骨髓炎。治疗应包括药物治疗和手术治疗相结合。
