Candida albicans sternal wound infections: a chronic and recurrent complication of median sternotomy

Clin Infect Dis. 2002 Dec 1;35(11):1316-20. doi: 10.1086/344192. Epub 2002 Nov 7.

Abstract

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.

MeSH terms

  • Aged
  • Antifungal Agents / therapeutic use
  • Candida albicans*
  • Candidiasis / drug therapy
  • Candidiasis / physiopathology*
  • Candidiasis / prevention & control
  • Chronic Disease
  • Coronary Artery Bypass / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / drug therapy
  • Postoperative Complications / microbiology*
  • Recurrence
  • Sternum / microbiology
  • Treatment Outcome
  • Wound Infection / drug therapy
  • Wound Infection / microbiology*

Substances

  • Antifungal Agents