Enterobacter-Related Deep Sternal Wound Infection After Cardiac Surgery with Delayed Negative-Pressure Wound Therapy Success: A Case Report.
Omar Al Ayoubi, Mohammad Alaa Aldakak, Grace Tannous et al.
✦ AI-curated · Sources linked
Case in brief
A 70-year-old man with diabetes, chronic obstructive pulmonary disease, hypertension, and heavy tobacco exposure developed systemic deterioration and severe sternal wound dehiscence with necrotic tissue and instability 20 days after discharge following CABG. The findings were consistent with deep sternal wound infection. Deep-tissue cultures grew Enterobacter spp, guiding antimicrobial therapy; species-level identification was unavailable, and mediastinitis or sternal osteomyelitis was not definitively confirmed radiologically. With delayed presentation and a complex wound, negative-pressure wound therapy was used as an adjunct. The wound progressively stabilized without immediate flap reconstruction, while delayed closure was planned with plastic surgery input.
What made this case unusual
The infection was associated with Enterobacter spp, a Gram-negative organism, and the patient presented with severe wound disruption after discharge. Delayed negative-pressure wound therapy was followed by clinical stabilization, but the report cannot establish its effectiveness.
Diagnostic / clinical pearl
Obtain deep-tissue cultures in suspected deep sternal wound infection: Enterobacter spp may be implicated, and microbiology can guide antimicrobial therapy.