Journal Article

<i>Candida albicans</i> Sternal Wound Infections: A Chronic and Recurrent Complication of Median Sternotomy

Preeti N. Malani, Shelly A. McNeil, Suzanne F. Bradley and Carol A. Kauffman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 11, pages 1316-1320
Published in print December 2002 | ISSN: 1058-4838
Published online December 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/344192
Candida albicans Sternal Wound Infections: A Chronic and Recurrent Complication of Median Sternotomy

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Eleven patients developed deep sternal wound infections due to Candida albicans after undergoing coronary artery bypass grafting (CABG) and were assessed. Six had sternal osteomyelitis, 1 had osteomyelitis and mediastinitis, and 4 had deep wound infections that probably involved bone. Seven patients experienced onset of infection within 28 days of CABG, but 4 experienced onset 48–150 days after CABG. Infections were characterized by a chronic, indolent course requiring prolonged treatment with an antifungal agent. Delay in initiating antifungal therapy was common. All patients were treated with fluconazole, and 1 also received amphotericin B. Six patients underwent incision and drainage, with or without wire removal, and 3 underwent sternectomy with placement of a muscle flap. Of 10 patients for whom follow-up data were available, 7 were cured after initial therapy (median duration of treatment, 6 months), and 3 experienced a relapse and required a second course of fluconazole.

Journal Article.  3014 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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