Samuels L E, Sharma S, Morris R J, Solomon M P, Granick M S, Wood C A, Brockman S K
Department of Cardiothoracic Surgery, Hahnemann University Hospital, Philadelphia, Pa, USA.
Arch Surg. 1996 Dec;131(12):1344-6. doi: 10.1001/archsurg.1996.01430240098014.
Sternal wound infection with atypical mycobacteria following open heart surgery is a rare occurrence. Previous reports have described infection by Mycobacterium fortuitum, an acid-fast bacillus and member of a larger family of rapidly growing mycobacteria. The source and mode of transmission have not been identified. Surgical debridement and the combination of aminoglycosides and quinolones have been shown to be effective methods of treatment. More recently, clarithromycin has been shown to be the drug of choice against rapidly growing mycobacteria. We describe a 49-year-old woman who underwent infundibular stenosis repair and in whom M fortuitum sternal osteomyelitis developed. Total sternectomy, muscle flap reconstruction, and antibiotic treatment successfully eradicated the infection.
心脏直视手术后发生非典型分枝杆菌胸骨伤口感染是一种罕见的情况。既往报告描述过偶然分枝杆菌感染,这是一种抗酸杆菌,属于快速生长分枝杆菌大家族的一员。其感染源和传播方式尚未明确。手术清创以及氨基糖苷类药物与喹诺酮类药物联合使用已被证明是有效的治疗方法。最近,克拉霉素已被证明是对抗快速生长分枝杆菌的首选药物。我们报告一名49岁女性,她接受了漏斗部狭窄修复手术,术后发生了偶然分枝杆菌胸骨骨髓炎。全胸骨切除术、肌瓣重建术和抗生素治疗成功根除了感染。