Candida albicans Infection of Sternum and Costal Cartilages: Combined Operative Treatment and Drug Therapy with 5-Fluorocytosine

Thomas, F; Martin, Charles E.; Fisher, R. Darryl; Alford, Robert H.

doi:10.1016/s0003-4975(10)64093-3

Cited by 25 publications

(5 citation statements)

References 18 publications

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“…Patients respond well to amphotericin B, ketoconazole, combination therapy with amphotericin B and flucytosine, and surgery. Despite earlier reports of the importance of surgical curettage (Thomas et al, 1977;Yap, Ravitch & Pataki, 1981), many cases of costochondritis resolve without surgical intervention (Dupont & Drouhet, 1985).…”

Section: Disseminated Candidosismentioning

confidence: 94%

Fungal infections in drug users

Leen

Brettle

1991

Journal of Antimicrobial Chemotherapy

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Fungal infections may account for 5-50% of serious infections in intravenous drug users, and for 5-50 per 100,000 hospital admissions. The fungi most commonly encountered are Candida and Aspergillus spp. Candidosis may be disseminated, with lesions in superficial structures, the eye and the skeletal system, or limited to the eye, the heart (as endocarditis) or the central nervous system. Aspergillosis usually presents as endophthalmitis or as central nervous system infection. Mucormycosis is also met with occasionally, and various fungi may cause endophthalmitis or endocarditis. Antifungal therapy for intravenous drug use-related infections is no different from that for similar mycoses in other patients, but the management of intravenous drug users requires considerable clinical skill.

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Section: Disseminated Candidosismentioning

confidence: 94%

Fungal infections in drug users

Leen

Brettle

1991

Journal of Antimicrobial Chemotherapy

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“…Table 4 summarises the recommended guidelines [ 303 , 304 ]. The reported experience for the treatment of sternal Candida infection is limited to a few clinical cases [ 305 , 306 , 307 , 308 ]. This is not entirely analogous to post-surgical sternal osteomyelitis, where the blood supply to the sternum after sternotomy has been interrupted and there is often foreign material (sternum wires, etc.…”

Section: Medical Managementmentioning

confidence: 99%

Prevention, Diagnosis and Management of Post-Surgical Mediastinitis in Adults Consensus Guidelines of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES)

Bouza

Alarcón

Fariñas

et al. 2021

JCM

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This is a consensus document of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES). These three entities have brought together a multidisciplinary group of experts that includes anaesthesiologists, cardiac and cardiothoracic surgeons, clinical microbiologists, infectious diseases and intensive care specialists, internal medicine doctors and radiologists. Despite the clinical and economic consequences of sternal wound infections, to date, there are no specific guidelines for the prevention, diagnosis and management of mediastinitis based on a multidisciplinary consensus. The purpose of the present document is to provide evidence-based guidance on the most effective diagnosis and management of patients who have experienced or are at risk of developing a post-surgical mediastinitis infection in order to optimise patient outcomes and the process of care. The intended users of the document are health care providers who help patients make decisions regarding their treatment, aiming to optimise the benefits and minimise any harm as well as the workload.

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“…Sternal osteomyelitis usually occurs after cardiothoracic surgery procedures. Candida can cause osteomyelitis either by direct implantation at the infected site (surgery procedures) [19], by spreading from a contiguous focus of infection (e.g. mediastinitis complicated by sternal osteomyelitis) [20], or, in the majority of cases, through the haematogenous route [4].…”

Section: Discussionmentioning

confidence: 99%

Case Report. Successful treatment of two cases of post‐surgical sternal osteomyelitis, due to Candida krusei and Candida albicans, respectively, with high doses of triazoles (fluconazole, itraconazole)

Petrikkos

Skiada

Sabatakou

et al. 2001

Mycoses

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Two female patients, aged 75 and 59 years, respectively, with candidal sternal osteomyelitis were successfully treated by the administration of triazoles. Both had developed post-operative wound infection after sternotomy for coronary artery by-pass grafting. Sternal osteomyelitis was confirmed by bone scans with technetium 99Tc and gallium 67Ga. The cultures, from the pus draining at the site of the sternotomy scar, grew Candida krusei in the first case. The fistula closed after a 9-week course of itraconazole therapy (800 mg daily, followed by 600 mg daily) and the patient completed a 6-month period of therapy. The second patient had underlying diabetes mellitus. Post-operatively she developed two fistulae draining pus on the sternum. The pus cultures grew C. albicans. Initial treatment with oral fluconazole (400 mg daily) failed. Subsequent treatment with liposomal amphotericin B also failed. A dramatic improvement was noted when the patient received high doses of fluconazole (800 mg daily). The fistulae gradually closed after 1 month. Oral fluconazole was continued for 6 months. The cure was confirmed by bone scans. Three years later, both patients remained well.

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Candida albicans Infection of Sternum and Costal Cartilages: Combined Operative Treatment and Drug Therapy with 5-Fluorocytosine

Cited by 25 publications

References 18 publications

Fungal infections in drug users

Fungal infections in drug users

Case Report. Successful treatment of two cases of post‐surgical sternal osteomyelitis, due to Candida krusei and Candida albicans, respectively, with high doses of triazoles (fluconazole, itraconazole)

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