[HSF] anaerobic late mediastinitis

[erdinç naseri]

Prasanna,
The only micro organism grown in culture was E.coli but the smell of the 
mediastinum was without any doubt was that of anaerobic infection.
erdinc


>From: prasannasimha <prasannasimha at gmail.com>
>Reply-To: OpenHeart-L at lists.hsforum.com
>To: OpenHeart-L at lists.hsforum.com
>Subject: Re: [HSF] anaerobic late mediastinitis
>Date: Fri, 23 Mar 2007 23:51:29 +0530
>
>Incidentally where was the anerobes - Ecoli is not an obligatory anaerobe - 
>It is a facultative aerobe.
>Prasanna
>
>erdinç naseri wrote:
>>
>>Dear forum members,
>>Opinion requested in the following case:
>>76 y/o male applied for CABG and ascending aortic aneurysm(6.5 cmm at STJ 
>>),No AI.Supracoronary  ascending aortic replacement with tubular graft and 
>>CABG X 1 one month ago.Had abdominal distention at postop 5.th day. No 
>>fever.Diagnosed as paralytic ileus. stoped oral intake and followed by 
>>general surgery guys for one week conservatively.WBC 4000 considered 
>>normal by them but I told them that this is relative neutropenia in open 
>>heart surgery ( ususally 12-20000 in postop period).After one week started 
>>oral feeding and discharged.Applied 2 days ago with anemia, weakness and 
>>abdominal distention.Hospitalized by my colleagues and followed medicaly( 
>>Genaral surgeons agreed on medical follow up),I saw the patient 
>>yesterday.No fever with Partial dehiscence and wound was dirty( oozing bad 
>>smelly fluid).Immediately taken to ICU and monitorized.Started inotropics 
>>for low cardiac out put and took the patient to the operation room.Opened 
>>the sternum .Very fetid odor and semiclear fluid.Grafts intact ,coronary 
>>graft open.Deep bradycardia and hypotension and arrest followed by mannual 
>>massage.Cardiac activity returned but with maximum inotropic agents.Opened 
>>both pleura and put a tube in each and one in suprasternal notch for 
>>irrigation.He is in ICU  with unremitting fever (39-40)and Culture 
>>revealed E.coli.
>>erdinc
>>
>>
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