Document Detail


Vertebral osteomyelitis after cardiac surgery.
MedLine Citation:
PMID:  12683568     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mediastinitis after open-heart surgery is a serious complication that has a decreasing incidence but still a significantly high mortality rate. Back pain may develop during the course of treatment for mediastinitis, and this should suggest vertebral osteomyelitis in the differential diagnosis. Diagnosis of vertebral osteomyelitis may be difficult because of the insidious onset and delayed diagnosis, and treatment may result in serious neurologic compromise and even death of the patient. METHODS: This retrospective study involves 5 patients who had open-heart surgery and mediastinitis that was further complicated by vertebral osteomyelitis. Average delay in diagnosis was 18 days after the onset of symptoms. Magnetic resonance imaging was the most helpful tool for diagnosis. Methicilline-resistant Staphylococcus aureus was identified as the responsible microorganism in all patients. Neurologic compromise occured (one paraplegia and one paraparesia) in 2 patients during medical treatment. RESULTS: Along with the medical treatment, all patients were surgically treated due to either one or more of the following reasons: unresolving symptoms, sudden neurologic compromise, or impaired spinal column stability despite appropriate conservative treatment. One patient died 10 days postoperatively. The mean follow-up period for the remaining 4 patients was 47 (12 to 95) months. Complete recovery was achieved, and they were able to return to their routine daily activities. CONCLUSIONS: Vertebral osteomyelitis should be borne in mind when a patient develops back pain during the course of mediastinitis. Suspicion, early diagnosis with appropriate imaging, and proper treatment are crucial to prevent catastrophic complications.
Authors:
Senol Akman; Ufuk Talu; Abdullah Göğüş; Mustafa Güden; Mustafa Sirvanci; Azmi Hamzaoğlu
Related Documents :
17023848 - Effect of high-dose intravenous dexamethasone on postlumbar discectomy pain.
7396348 - The cervicolumbar syndrome.
20091188 - Sagittal spinal alignment in patients with lumbar disc herniation.
11458148 - Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy:...
2483018 - Thromboprophylaxis in hip arthroplasty. dextran with graded compression or preoperative...
21140158 - Macrosomia prediction using different maternal and fetal parameters in women with 50 g...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  75     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-09     Completed Date:  2003-04-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1227-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery, Sişli Etfal Research and Training Hospital, Istanbul, Turkey.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Surgical Procedures*
Female
Humans
Magnetic Resonance Imaging
Male
Mediastinitis / complications
Methicillin Resistance
Middle Aged
Osteomyelitis / diagnosis,  etiology*,  therapy
Postoperative Complications
Retrospective Studies
Spinal Diseases / diagnosis,  etiology*
Staphylococcal Infections / diagnosis,  etiology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Atheroembolism in cardiac surgery.
Next Document:  Off-pump technique for the treatment of ventricular myocardial echinococcosis.