[HSF] Possible infected Freestyle

[John Schor]

Yes. I recently operated on an 81 yo woman with an infected aorto-bi- 
fem graft. Found pus around the graft that tracked all the way up. Gm  
stain many WBC's, no org's. Cultures never grew anything. Removed  
graft and did extraanatomic bypass. She had pre-op bony destruction  
of the lumbar spine which was becoming unstable. It had to be  
infected.......right? Plan for lifetime abx but don't know what to  
treat.
John

John Schor, MD
PO Box 4445
Cottonwood, AZ 86326


On May 1, 2007, at 7:24 AM, tdmartin2000 at aol.com wrote:

> Just for discussion sake- has anyone ever heard of a "sterile "  
> abscess where there are multiple wbc's but no bacteria?
>
> Tom Martin
> U of Florida
> Gainesville
>
> -----Original Message-----
> From: Hgrmd at aol.com
> To: OpenHeart-L at lists.hsforum.com
> Sent: Tue, 1 May 2007 8:11 AM
> Subject: Re: [HSF] Possible infected Freestyle
>
>
> Ani,
>   You are even more binary and concrete than yours truly!!   Though  
> I'm the
> first to profess that I'm not an aortic expert, I have seen and   
> read of
> instances where conservative therapy has worked well for  
> mediastinal  infections
> in
> the presence of aortic grafts.  Coselli and others have  written  
> for years
> about treating some of these cases with omentum and life long   
> antibiotics. As
> long as the patient is closely watched, the risk of waiting is  not  
> that great.
>
> Also, exchanging a Free Style for a homograft in an 80 yo  by a new  
> surgeon
> carries a hell of a lot of risk no matter how you slice  it.
> Hal
>
>
>
> ************************************** See what's free at http:// 
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