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Sternectomy for Candida albicans sternal osteomyelitis after left ventricular assist device implantation
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  • Mathias van Hemelrijck,
  • Michelle Frank,
  • Annelies Zinkernagel,
  • Ronny Buechel,
  • Juri Sromicki,
  • Markus Wilhelm,
  • Holger Klein,
  • Barbara Hasse,
  • carlos mestres
Mathias van Hemelrijck
University Hospital Zurich

Corresponding Author:mathias.vanhemelrijck@usz.ch

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Michelle Frank
University Hospital Zurich
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Annelies Zinkernagel
University Hospital Zurich
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Ronny Buechel
University Hospital Zurich
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Juri Sromicki
University Hospital Zurich
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Markus Wilhelm
University Hospital Zurich
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Holger Klein
University Hospital Zurich
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Barbara Hasse
University Hospital Zurich
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carlos mestres
University Hospital Zurich
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Abstract

Fungal osteomyelitis is uncommon after cardiac surgery. A case of Candida albicans and S. epidermidis osteomyelitis with device infection after implantation of a left ventricular assist device in a male patient is presented. After confirmation with microbiological and radiological examinations, debridement was performed. Surgical specimens grew C. albicans and S. epidermidis. Fluconazole, daptomycin and negative pressure wound therapy failed to achieve healing. Total sternectomy and pectoralis muscle flap reconstruction were performed. There was no recurrent infection for C. albicans on a prolonged antifungal regime. The combination of antifungal therapy and aggressive surgical debridement may be useful to control fungal osteomyelitis.