Sternectomy for Candida albicans sternal osteomyelitis after left ventricular assist device implantation.
Mathias Van HemelrijckMichelle FrankAnnelies S ZinkernagelRonny BuechelJuri SromickiMarkus J WilhelmHolger KleinBarbara HasseCarlos-Alberto MestresPublished in: Indian journal of thoracic and cardiovascular surgery (2021)
Fungal osteomyelitis is an uncommon complication after cardiac surgery and associated with high mortality. A case of Candida albicans and Staphylococcus epidermidis osteomyelitis with device infection after implantation of a left ventricular assist device in a 60-year-old male patient is presented here. After clinical identification and confirmation with microbiological examinations and fluorodeoxyglucose positron emission tomography (FDG-PET) scan, debridement was performed. Surgical specimens grew C. albicans and S. epidermidis. Fluconazole, daptomycin, and negative pressure wound therapy were initiated, but failed to achieve healing. Total sternectomy and pectoralis flap reconstruction were performed. There was no recurrent infection for C. albicans on a prolonged antifungal regime. The combination of antifungal therapy and aggressive surgical debridement may be useful to control fungal osteomyelitis.
Keyphrases
- candida albicans
- positron emission tomography
- biofilm formation
- left ventricular assist device
- computed tomography
- pet ct
- pet imaging
- magnetic resonance imaging
- cardiovascular disease
- magnetic resonance
- case report
- cystic fibrosis
- methicillin resistant staphylococcus aureus
- type diabetes
- stem cells
- risk factors
- contrast enhanced
- mesenchymal stem cells
- cell therapy
- escherichia coli
- wound healing