[A case report of mediastinitis due to methicillin resistant Staphylococcus aureus after total aortic arch replacement].
A 78-year-old man underwent total aortic arch replacement for ruptured aortic arch aneurysm. Two weeks after the surgery, high fever and leucocytosis developed. He was placed on a regimen of antibiotics. However, mediastinitis eventually ensued five weeks later with the pus draining from the sternotomy wound. The culture revealed a Methicillin resistant staphylococcus aureus. The infected tissue was debrided from the mediastinal cavity 40 days postoperatively. The cavity was kept open and was intermittently irrigated with 2% Providone-iodine for three days. Subsequently, an omental graft was placed. The infection successfully subsided gradually and the patient has been well for a year and a half after the initial surgery. The procedure is considered to be extremely effective for the management of a drastic infection involving thoracic aortic prosthesis.
Asano
S
S
Department of Cardiovascular Surgery, Tsurumai Hospital, Ichihara, Japan.
Murayama
H
H
Ishida
A
A
Nakagawa
Y
Y
Ito
M
M
Sudo
Y
Y
D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000382:microbiology*; D016106:Methicillin Resistance; D016459:Prosthesis-Related Infections / Q000209:etiology*; D013203:Staphylococcal Infections; D013211:Staphylococcus aureus / Q000187:drug effects*