[HSF] Possible infected Freestyle

[Mark Levinson]

On May 1, 2007, at 9:24 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?

Absolutely.   Foreign body reactions do this...and I suspect that is  
what this patient has.
Sterile granulomas form around prosthetic devices.    All dacron  
grafts have fluid around
them with white cells, but no bacteria if you aspirate them at the  
right time after surgery.
If you get an abd CAT after a AAA, you often see fluid around the  
graft.    It has breakdown
products of blood and often inflammatory cells.    Its part of the  
foreign body reaction
and the healing process....inflammation is the first phase of healing.

In the absence of clinical sign/symptoms of infection or positive  
cultures, this
patient can just wait and be followed.

Mark

>
> 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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