Poststernotomy Osteomyelitis Presenting with Severe Sepsis and Rhabdomyolysis
A 39-year-old male, who recently underwent a composite valve graft of the aortic root and ascending aorta for bicuspid aortic valve and aortic root aneurysm, was hospitalized for severe sepsis, rhabdomyolysis (creatine kinase 29000 U/L), and severe liver dysfunction (AST > 7000 U/L, ALT 4228 U/L,...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2016/4507012 |
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| _version_ | 1832558420600815616 |
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| author | Eugene M. Tan Melissa Lyle Kelly Cawcutt Zelalem Temesgen |
| author_facet | Eugene M. Tan Melissa Lyle Kelly Cawcutt Zelalem Temesgen |
| author_sort | Eugene M. Tan |
| collection | DOAJ |
| description | A 39-year-old male, who recently underwent a composite valve graft of the aortic root and ascending aorta for bicuspid aortic valve and aortic root aneurysm, was hospitalized for severe sepsis, rhabdomyolysis (creatine kinase 29000 U/L), and severe liver dysfunction (AST > 7000 U/L, ALT 4228 U/L, and INR > 10). Cardiac magnetic resonance imaging (MRI) findings were consistent with sternal osteomyelitis with a 1.5 cm abscess at the inferior sternotomy margin, which was contiguous with pericardial thickening. Aspiration and culture of this abscess did not yield any organisms, so he was treated with vancomycin and cefepime empirically for 4 weeks. Because this patient was improving clinically on antibiotics and did not show external signs of wound infection, there was no compelling indication for sternectomy. This patient’s unusual presentation with osteomyelitis and rhabdomyolysis has never been reported and is crucial for clinicians to recognize in order to prevent delays in diagnosis. |
| format | Article |
| id | doaj-art-e9c8fcb60b8d431d99ab6df98e0363e2 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-e9c8fcb60b8d431d99ab6df98e0363e22025-02-03T01:32:25ZengWileyCase Reports in Medicine1687-96271687-96352016-01-01201610.1155/2016/45070124507012Poststernotomy Osteomyelitis Presenting with Severe Sepsis and RhabdomyolysisEugene M. Tan0Melissa Lyle1Kelly Cawcutt2Zelalem Temesgen3Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USAMayo Clinic, 200 First Street SW, Rochester, MN 55905, USAUniversity of Nebraska Medical Center, S. 42nd Street and Emile Street, Omaha, NE 68198, USAMayo Clinic, 200 First Street SW, Rochester, MN 55905, USAA 39-year-old male, who recently underwent a composite valve graft of the aortic root and ascending aorta for bicuspid aortic valve and aortic root aneurysm, was hospitalized for severe sepsis, rhabdomyolysis (creatine kinase 29000 U/L), and severe liver dysfunction (AST > 7000 U/L, ALT 4228 U/L, and INR > 10). Cardiac magnetic resonance imaging (MRI) findings were consistent with sternal osteomyelitis with a 1.5 cm abscess at the inferior sternotomy margin, which was contiguous with pericardial thickening. Aspiration and culture of this abscess did not yield any organisms, so he was treated with vancomycin and cefepime empirically for 4 weeks. Because this patient was improving clinically on antibiotics and did not show external signs of wound infection, there was no compelling indication for sternectomy. This patient’s unusual presentation with osteomyelitis and rhabdomyolysis has never been reported and is crucial for clinicians to recognize in order to prevent delays in diagnosis.http://dx.doi.org/10.1155/2016/4507012 |
| spellingShingle | Eugene M. Tan Melissa Lyle Kelly Cawcutt Zelalem Temesgen Poststernotomy Osteomyelitis Presenting with Severe Sepsis and Rhabdomyolysis Case Reports in Medicine |
| title | Poststernotomy Osteomyelitis Presenting with Severe Sepsis and Rhabdomyolysis |
| title_full | Poststernotomy Osteomyelitis Presenting with Severe Sepsis and Rhabdomyolysis |
| title_fullStr | Poststernotomy Osteomyelitis Presenting with Severe Sepsis and Rhabdomyolysis |
| title_full_unstemmed | Poststernotomy Osteomyelitis Presenting with Severe Sepsis and Rhabdomyolysis |
| title_short | Poststernotomy Osteomyelitis Presenting with Severe Sepsis and Rhabdomyolysis |
| title_sort | poststernotomy osteomyelitis presenting with severe sepsis and rhabdomyolysis |
| url | http://dx.doi.org/10.1155/2016/4507012 |
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