Late-onset chest wall abscess due to a biodegradable rib pin infection after lung transplantation.
A 55-year-old man with end-stage emphysema underwent a right single-lung transplantation through a posterolateral thoracotomy. The fifth rib was divided and fused back using a biodegradable pin made of polylactide acid and hydroxyapatite. Two weeks postoperatively, he suffered from central vein catheter-related sepsis due to methicillin-sensitive Staphylococcus aureus. After being successfully treated for sepsis, he was discharged. However, 3 months later, computed tomography revealed multiple loculated abscesses in the chest wall and the right pleural space. Reoperative thoracotomy revealed abscesses mainly located around the fifth rib, where the pin was inserted. Both cultures of the abscess and the fifth rib were positive for methicillin-sensitive S. aureus, which suggested that the rib pin was the cause of the secondary infection. This case suggests the rib pins, even if they are biodegradable, could have a risk of infections side effect especially for the immunosuppressed patients.
Departments of Thoracic Surgery, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku1, Kyoto, 606-8507, Japan.
Yasufumi
Y
Goda
Departments of Thoracic Surgery, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku1, Kyoto, 606-8507, Japan. fengshic@kuhp.kyoto-u.ac.jp.
Toyofumi F
TF
Chen-Yoshikawa
National Center for Geriatrics and Gerontology, Nagoya, Japan.
Masaaki
M
Kusunose
Departments of Thoracic Surgery, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku1, Kyoto, 606-8507, Japan.
Masatsugu
M
Hamaji
Departments of Thoracic Surgery, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku1, Kyoto, 606-8507, Japan.
Hideki
H
Motoyama
Departments of Thoracic Surgery, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku1, Kyoto, 606-8507, Japan.
Kyoko
K
Hijiya
Departments of Thoracic Surgery, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku1, Kyoto, 606-8507, Japan.
Akihiro
A
Aoyama
Departments of Thoracic Surgery, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku1, Kyoto, 606-8507, Japan.
Hiroshi
H
Date
D000038:Abscess / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D020341:Absorbable Implants / Q000009:adverse effects*; D001858:Bone Nails / Q000009:adverse effects; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D012272:Ribs / Q000000981:diagnostic imaging / Q000601:surgery; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D035441:Thoracic Wall / Q000000981:diagnostic imaging / Q000382:microbiology*; D013908:Thoracotomy / Q000295:instrumentation; D014057:Tomography, X-Ray Computed
Biodegradable rib pin; Chest wall abscess; Lung transplantation