Proteus Mediastinitis Causing Fatal Pseudoaneurysm following Aortic Valve Replacement. (28th November 2013)

• Record Type: Journal Article
• Authors: Nazir, Sarfraz; Jeffery, John; Tenovici, Alexandra-Alice; D'Costa, Horace
• Other Names: Pigula Frank A. Academic Editor.
• Is Part Of: Case reports in medicine. Volume 2013(2013)
• Publication Date: 2013-11-28
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Case Reports; Periodicals; 610
• DOI: 10.1155/2013/920327
• Languages: English
• ISSNs: 1687-9627

Abstract

Abstract : We report an unusual case of Gram-negative mediastinitis following aortic valve replacement via median sternotomy. The patient presented two months after surgery following a urinary tract infection in septic shock with a discharging sternal wound and blood cultures positive for Proteus mirabilis . Imaging revealed a large anterior mediastinal abscess and aortic pseudoaneurysm which subsequently ruptured resulting in fatality. Gram-negative mediastinitis is a rare complication of cardiac surgery that can present late following initial clinical improvement and should be considered when "remote site" infections are present. Computerised Tomography scanning has a role to play in the identification of this.