Sternal Osteomyelitis Due to Mycobacterium tuberculosis Following Coronary Artery Bypass Surgery

Rubinstien, Eytan; Lehmann, Timothy

doi:10.1093/clinids/23.1.202

Cited by 24 publications

(8 citation statements)

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“…Tuberculosis of the sternum is rarely reported and accounts for 1.5 % of bone and joint TB cases [24,60]. Primary sternal TB is relatively more common than TB secondary to cardiopulmonary surgery [24].…”

Section: Sternal Tuberculosismentioning

confidence: 99%

Bone and joint tuberculosis

2012

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Section: Sternal Tuberculosismentioning

confidence: 99%

Bone and joint tuberculosis

2012

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“…In 6 (42.9%) patients, one or more predictive risk factors for sternal wound infection were determined, which were diabetes mellitus in 4 (66.7%) (of those, one patient was also associated with hypertension, hyperlipidemia, and diabetic nephropathy requiring persisted dialysis, and another patient was associated with lung tuberculosis) and tuberculosis contact in 2 (33.3%) patients. The locations of infections in the sternum were described in 6 patients, including 1 (16.7%) in the manubrium [ 16 ] , 1 (16.7%) in the upper portion [ 18 ] , 2 (33.3%) in the lower portion [ 11 , 15 ] , 1 (16.7%) in the body of the sternum [ 20 ] , and 1 (16.7%) that was described as "9 cm below the suprasternal notch" [ 14 ] . Sternal destruction was noted on chest X-ray and on chest computed tomography in 2 (14.3%) patients each.…”

Section: Resultsmentioning

confidence: 99%

“…Associated Staphylococcus aureus infection was found in 2 patients [ 11 , 15 ] . Anti-tuberculous treatment was indicated in 12 patients.…”

Section: Resultsmentioning

confidence: 99%

Sternal wound tuberculosis following cardiac operations: a review

Yuan¹

2014

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveThe diagnosis and treatment of sternal wound infections with mycobacteria are challenging. Such an infection is often associated with a delayed diagnosis and improper treatment that may lead to a worsened clinical outcome. The present study is designed to highlight its clinical features so as to facilitate a prompt diagnosis and timely treatment.MethodsMEDLINE, Highwire Press, and Google search engine were searched for publications in the English language, with no time limit, reporting on sternal wound infection caused by tuberculosis after cardiac surgery.ResultsA total of 12 articles reporting on 14 patients were included in this study. Coronary artery bypass grafting was the underlying surgical procedure in more than half of the cases. Purulent discharge and cold abscess were the two main presenting symptoms. Diagnosis of sternal wound infection was evidenced in all 14 patients by different investigations, with culture of samples being the most sensitive method of identifying the pathogen. Good response to first-line anti-tuberculous agents was noted. Almost all patients required surgical debridement/resection and, sometimes, sternal reconstruction. A delayed diagnosis of sternal wound infection may lead to repeated recurrences. A comparison between patients with sternal wound infection due to tuberculosis and non-tuberculous mycobacterial infections showed that the former infections took an even longer period of time. Comparisons also revealed patients with sternal tuberculosis infection had a significantly higher mortality than patients with sternal non-tuberculous infection (29.2% vs. 0%, P=0.051).ConclusionSternal infection caused by tuberculosis after cardiac surgery has a longer latency, better response to first-line drugs, and better outcomes in comparison with non-tuberculous sternal infection. Early diagnosis and early anti-tuberculous treatment can surely improve the patients' prognosis.

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“…Systemic manifestations such as cough [5, 7], fever [1, 2, 5, 8], night sweats [6–8], weight loss [2, 5–8], malaise [6], and fatigue [6], even when reported, are generally less dramatic. Injury to the local site has been reported as a trigger in a few cases [7, 10]. …”

Section: Discussionmentioning

confidence: 99%

A Swelling over Sternum in a Child: Reminder of an Uncommon Diagnosis

Joshi

Bavdekar

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2016

Case Reports in Pediatrics

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Lack of awareness about isolated tubercular osteomyelitis of the sternum resulted in a delay in diagnosing the condition in an eleven-year-old girl who presented with a gradually increasing swelling over the sternum. Radiological, histological, and microbiological investigations helped diagnose the condition and the child responded well to antitubercular therapy (ATT) and surgical debridement. The report provides a brief description about the various management options available.

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Sternal Osteomyelitis Due to Mycobacterium tuberculosis Following Coronary Artery Bypass Surgery

Cited by 24 publications

References 0 publications

Bone and joint tuberculosis

Bone and joint tuberculosis

Sternal wound tuberculosis following cardiac operations: a review

A Swelling over Sternum in a Child: Reminder of an Uncommon Diagnosis

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