Barzaghi N, Emmi V, Mencherini S, Minzioni G, Marone P, Minoli L
Department of Anesthesiology, University of Pavia, Policlinico San Matteo, Italy.
Chest. 1994 Apr;105(4):1275-7. doi: 10.1378/chest.105.4.1275.
Sternal osteomyelitis due to Aspergillus fumigatus after cardiac surgery occurred in two nonimmunosuppressed patients. The clinical features of the infection were markedly different in the two cases. In the first patient, sepsis showed a late and insidious onset followed by slow progression. In the second case, fungi were isolated from wound swabs within a few days of surgery and the clinical picture showed acute onset and rapid progression. Only a few cases of sternal osteomyelitis due to Aspergillus have been described previously after cardiac surgery. Aspergillus infection should be considered in the differential diagnosis of mediastinitis after cardiac surgery, especially in a clinical setting of otherwise unexplained sepsis or nonhealing wound despite apparently adequate treatment.
两例非免疫抑制患者在心脏手术后发生了由烟曲霉引起的胸骨骨髓炎。两例感染的临床特征明显不同。第一例患者，脓毒症起病较晚且隐匿，随后进展缓慢。第二例患者，术后数天伤口拭子中分离出真菌，临床表现为急性起病且进展迅速。此前仅有少数几例心脏手术后由曲霉菌引起的胸骨骨髓炎的报道。心脏手术后纵隔炎的鉴别诊断中应考虑曲霉菌感染，尤其是在出现原因不明的脓毒症或尽管治疗看似充分但伤口仍不愈合的临床情况下。
