PDF(Pubmed)
Abstract：
A 77-year-old woman underwent surgical aortic valve replacement via hemisternotomy. Her post-operative course was unremarkable. Owing to travel and contact restrictions during the COVID pandemic, she was unable to attend routine follow up. She continued review with her local medical officer in regional New South Wales. Post 6 months following her index surgery, she was referred to the Infectious Disease Clinic of her local hospital with a non-healing lesion at the base of her hemi-sternotomy wound. Computed tomography revealed a deep sternal wound infection which extended deep to bone. She was admitted to hospital for treatment. The primary pathogen identified was Lomentospora prolificans-a dangerous fungus that affects immunosuppressed patients. Strong antifungal and adjunctive antibiotics did not contribute much to clearance of infection. Radical surgical debridement was required to obtain clean tissue margins.
摘要：
一名77岁的妇女通过半轴结切术接受了外科主动脉瓣置换术。她的术后过程并不引人注目。由于COVID大流行期间的旅行和接触限制，她无法参加例行随访。她继续与新南威尔士州地区的当地医务人员进行审查。索引手术后6个月，她被转诊到当地医院的传染病诊所，胸骨半切开术伤口底部有一个不愈合的病变。计算机断层扫描显示胸骨伤口深度感染，并延伸至骨骼。她被送进医院接受治疗。确定的主要病原体是Lomentosporaprolificans-一种影响免疫抑制患者的危险真菌。强大的抗真菌和辅助抗生素对清除感染没有太大贡献。需要进行根治性手术清创术以获得清洁的组织边缘。
