Mycoplasma hominis mediastinitis after acute aortic dissection repair.
We report a case of ascending aortic graft infection by an atypical bacteria, Mycoplasma hominis, with mediastinitis, a dreaded complication after cardiac surgery. A 55-year-old patient underwent ascending aorta replacement for acute type A dissection. He developed sternal instability and purulent discharge, requiring sternal wire removal and debridement. Cultures were initially sterile, but showed M. hominis infection after a significant delay and in specific culture media. The patient was treated with doxycycline and moxifloxacine. Cultures became negative and the sternum was closed on the 28th postoperative day after the first debridement. Recovery was favorable, with no signs of infection. Antibiotics were continued for one year. The patient is still asymptomatic 16 months after antibiotic interruption. Atypical organisms should be considered in the differential diagnosis of acute mediastinitis of unknown etiology after routine microbiological investigations.
Myers
Patrick O
PO
Division of Cardiovascular Surgery, Geneva University Hospital and School of Medicine, 4, Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland. patrick.myers@hcuge.ch
Khabiri
Ebrahim
E
Greub
Gilbert
G
Kalangos
Afksendiyos
A
D000784:Aortic Dissection / Q000601:surgery*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001014:Aortic Aneurysm / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D003131:Combined Modality Therapy; D003646:Debridement; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000382:microbiology* / Q000628:therapy; D008875:Middle Aged; D009175:Mycoplasma Infections / Q000382:microbiology* / Q000628:therapy; D019535:Mycoplasma hominis / Q000302:isolation & purification*; D054843:Negative-Pressure Wound Therapy; D016459:Prosthesis-Related Infections / Q000382:microbiology* / Q000628:therapy; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome
D000890:Anti-Infective Agents