title: Deep sternal wire infection resulting in severe pulmonary valve endocarditis.
abstract: Right-sided infective endocarditis is uncommon, comprising less than 5% of all cases of endocarditis. This is primarily seen in patients with drug abuse, long-term intravenous catheters, and congenital malformations, or a combination of these. Isolated pulmonary valve endocarditis is difficult to recognize due to its rarity, minimal cardiac manifestations, and predominance of pulmonary infections secondary to embolization of the vegetations. We describe an unusual case of chronic sternal wound infection and migration of an infected braided sternal wire causing right ventricular outflow tract and pulmonary valve endocarditis, which necessitated a complicated reoperation including pulmonary valve replacement with a homograft.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Sekar S
authors.initials: SS
authors.lastname: Bhavani
authors.forename: Worawong
authors.initials: W
authors.lastname: Slisatkorn
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Rehm
authors.forename: Gosta B
authors.initials: GB
authors.lastname: Pettersson
mesh_terms: D000368:Aged; D001864:Bone Wires / Q000009:adverse effects*; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D003646:Debridement; D003951:Diagnostic Errors; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D006335:Heart Injuries / Q000209:etiology*; D006352:Heart Ventricles / Q000293:injuries*; D006801:Humans; D008297:Male; D010000:Osteitis / Q000150:complications*; D011014:Pneumonia / Q000175:diagnosis; D011664:Pulmonary Valve / Q000382:microbiology / Q000601:surgery; D011665:Pulmonary Valve Insufficiency / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012501:Saphenous Vein / Q000637:transplantation; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D013249:Sternum / Q000382:microbiology / Q000601:surgery; D013529:Surgical Wound Dehiscence / Q000150:complications; D013530:Surgical Wound Infection / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D013536:Suture Techniques; D014640:Vancomycin / Q000627:therapeutic use; D014694:Ventricular Outflow Obstruction / Q000209:etiology / Q000601:surgery; D014951:Wounds, Stab / Q000209:etiology*
chemical_list: D014640:Vancomycin