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Mycoplasma hominis mediastinitis after acute aortic dissection repair

Published in Interactive cardiovascular and thoracic surgery. 2010, vol. 11, no. 6, p. 857-8
Abstract 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.
Keywords Aneurysm, Dissecting/surgeryAnti-Infective Agents/therapeutic useAortic Aneurysm/surgeryBlood Vessel Prosthesis/adverse effectsBlood Vessel Prosthesis Implantation/adverse effects/instrumentationCombined Modality TherapyDebridementHumansMaleMediastinitis/microbiology/therapyMiddle AgedMycoplasma Infections/microbiology/therapyMycoplasma hominis/isolation & purificationNegative-Pressure Wound TherapyProsthesis-Related Infections/microbiology/therapyReoperationTime FactorsTreatment Outcome
PMID: 20826555
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Article (Published version) (110 Kb) - public document Free access
Research group Chirurgie cardio-vasculaire (105)
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MYERS, Patrick Olivier et al. Mycoplasma hominis mediastinitis after acute aortic dissection repair. In: Interactive cardiovascular and thoracic surgery, 2010, vol. 11, n° 6, p. 857-8. doi: 10.1510/icvts.2010.244608 https://archive-ouverte.unige.ch/unige:32389

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Deposited on : 2013-12-18

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