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The Journal of Cardiovascular Surgery 1999 October;40(5):675-7

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Mediastinitis due to Gordona spu­ti ­after ­CABG

Kuwabara M., Onitsuka T., Nakamura K., Shimada M.*, Ohtaki S.*, Mikami Y.**

From the Second Department of Surgery
*Division of Biological Examination Center of Laboratory Medicine Miyazaki Medical College, Miyazaki, Japan
**Research Center for Pathogenic Fungi and Microbial Toxicoses, Chiba University, Chiba, Japan


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Genus Gordona is includ­ed in mycol­ic ­acid con­tain­ing bac­te­ria. This ­genus infec­tion is ­very ­rare and ­occurs clas­si­cal­ly in immu­no-com­pro­mised ­patients. We ­report a ­patient who devel­oped med­i­as­tin­itis due to Gordona spu­ti ­after cor­o­nary ­artery ­bypass graft­ing (­CABG) ­using ­left inter­nal mam­mary ­artery. Immuno-com­pro­mised fac­tors ­were not ­noticed in ­this ­case but ­postoper­a­tive bleed­ing, the ­most impor­tant ­risk fac­tor of med­i­as­tin­itis, was ­found in his ­course. The treat­ment was anti­bi­o­tic ther­a­py, sur­gi­cal ­soft tis­sue debride­ment and ­open irri­ga­tion ­with ­dilute pov­i­done-­iodine solu­tion. However, infec­tious reac­tion con­tin­ued and Gordona spu­ti repeat­ed cul­tured ­from ­wound. Next pro­ce­dure, debride­ment of ster­nal ­bone and omen­tal trans­fer, was per­formed and ­skin was ­closed pri­mar­i­ly. Inflammatory reac­tion was atten­u­at­ed and the ­wound was ­healed. Broad debride­ment and omen­tal trans­fer ­were ­very effec­tive for med­i­as­tin­itis due to Gordona spu­ti ­after ­CABG.

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