[HSF] anaerobic late mediastinitis

[psimha]

Funny to think that theworld was not stunned when they used a fungus  
basically a rotting thing from a piece of bread to cure many diseases 
(Penicillin). That did not make people "curdle"
How about spider webs , snake venom , potato peel etc etc.
Prasanna
Ajit Damle wrote:
> I am too stunned to comment on "Yogurt in mediastinum".
>
> To my unsophisticated mind it seems that infection (leading to eventual
> death) will not be controlled unless the prosthetic graft is replaced with a
> homograft, if it does.
>
> Does anyone know if infection in a vascular graft in such a situation can be
> controlled without replacing it?
>
> Ajit Damle
>
>
>
> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of prasannasimha
> Sent: Friday, March 23, 2007 11:04 AM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] anaerobic late mediastinitis
>
> Keep chest open and I will tell something that will make your blood 
> curdle but has worked well.
> Apply fresh curds (Yoghurt) to the wound. This will displace the E coli 
> and the colonized lactobacillus is nonpathogenic ansd will get 
> eliminated. Later you can mobilize flaps/ close with drains.
> IV antibiotics after mediastinal cultures etc etc are obvious.
> Look for diverticulitis especially if a meat eater.
> 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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