Extent-Guided Staged Management of Localized Late-Onset MSSA Sternal Infection after Bilateral Lung Transplantation: A Case Report.
Tomohiro Baba, Shin Tanaka, Haruchika Yamamoto et al.
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Case in brief
A 38-year-old woman developed methicillin-susceptible Staphylococcus aureus (MSSA) sternal infection with bacteremia seven months after bilateral lung transplantation. CT showed an abscess around the sternal wires, and imaging plus operative assessment found infection limited to extrathoracic peri-sternal tissues, with no communication with the thoracic cavity. She underwent debridement, drainage, wire removal, antimicrobial therapy, and staged negative-pressure wound therapy. After infection control and granulation, delayed primary closure was performed 60 days after debridement without flap reconstruction. She was discharged on day 77 and had no recurrence eight months after closure.
What made this case unusual
Despite bacteremia and a post-transplant sternal infection, the infection was localized outside the thoracic cavity, allowing staged closure without flap reconstruction.
Diagnostic / clinical pearl
In late-onset sternal infection after lung transplantation, assess the extent of infection with imaging and operative findings; confirming whether it communicates with the thoracic cavity can inform staged management.