title: Intracardiac abscess with cutaneous fistula secondary to ventricular septal defect repair simulating sternal wound infection.
abstract: Cutaneous fistula as a clinical presentation of intracardiac abscess of the right side is such an unusual occurrence that it has not until now been reported in the English-language medical literature. We present a rare case of right-sided infective endocarditis caused by Achromobacter xylosoxidans in which recurrent infection presented as sternal wound discharge. The infection was found to have an intracardiac origin and was successfully managed by radical débridement on cardiopulmonary bypass.
authors: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195.
authors: Aldo Elmer
authors: AE
authors: Rafael
authors: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195.
authors: Suresh
authors: S
authors: Keshavamurthy
authors: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195.
authors: Edgardo
authors: E
authors: Sepulveda
authors: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195.
authors: Cyndee Cruz
authors: CC
authors: Miranda
authors: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195.
authors: Toshihiro
authors: T
authors: Okamoto
authors: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195.
authors: Gosta Bengt
authors: GB
authors: Pettersson
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000382:microbiology*; D042441:Achromobacter denitrificans / Q000302:isolation & purification*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D003646:Debridement; D003937:Diagnosis, Differential; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012086:Reoperation; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000382:microbiology*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents
keywords: Abscess, intracardiac; Achromobacter xylosoxidans; congenital heart disease; endocarditis, infective; fistula, cutaneous; septal defect, ventricular