Near-fatal complications of tracheotomy infections and their prevention.
Infectious complications of tracheotomy range from minor to potentially fatal. Three cases are presented: clavicular osteomyelitis; innominate artery blowout with mediastinitis; and the first reported case of necrotizing fasciitis involving the chest wall related to tracheotomy infection. All patients were debilitated, with one diabetic and another steroid-dependent. Infectious sequelae occurred as late as 8 weeks following tracheotomy. The mechanism, treatment, and prevention of tracheotomy infections are reviewed. Indications for the creation of a permanent but reversible tracheostome should be expanded to prevent infections in debilitated or immunosuppressed patients in whom decannulation is unlikely.
Wang
R C
RC
Division of Otolaryngology, Albany Medical College, New York.
Perlman
P W
PW
Parnes
S M
SM
D005208:Fasciitis / Q000209:etiology; D005260:Female; D006192:Haemophilus Infections / Q000517:prevention & control*; D006193:Haemophilus influenzae; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology; D008875:Middle Aged; D009336:Necrosis; D011512:Proteus Infections / Q000517:prevention & control*; D011513:Proteus mirabilis; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014140:Tracheotomy