Sternectomy for Candida albicans sternal osteomyelitis after left
ventricular assist device implantation
- Mathias van Hemelrijck,
- Michelle Frank,
- Annelies Zinkernagel,
- Ronny Buechel,
- Juri Sromicki,
- Markus Wilhelm,
- Holger Klein,
- Barbara Hasse,
- carlos mestres
Abstract
Fungal osteomyelitis is uncommon after cardiac surgery. A case of
Candida albicans and S. epidermidis osteomyelitis with device infection
after implantation of a left ventricular assist device in a male patient
is presented. After confirmation with microbiological and radiological
examinations, debridement was performed. Surgical specimens grew C.
albicans and S. epidermidis. Fluconazole, daptomycin and negative
pressure wound therapy failed to achieve healing. Total sternectomy and
pectoralis muscle flap reconstruction were performed. There was no
recurrent infection for C. albicans on a prolonged antifungal regime.
The combination of antifungal therapy and aggressive surgical
debridement may be useful to control fungal osteomyelitis.