| Vertebral osteomyelitis after cardiac surgery. | |
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MedLine Citation:
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PMID: 12683568 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Senol Akman; Ufuk Talu; Abdullah Göğüş; Mustafa Güden; Mustafa Sirvanci; Azmi Hamzaoğlu |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 75 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2003 Apr |
Date Detail:
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Created Date: 2003-04-09 Completed Date: 2003-04-25 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1227-31 Citation Subset: AIM; IM |
Affiliation:
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Department of Orthopaedic Surgery, Sişli Etfal Research and Training Hospital, Istanbul, Turkey. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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
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