Candida albicans Sternal Wound Infections: A Chronic and Recurrent Complication of Median Sternotomy
Abstract
Eleven patients developed deep sternal wound infections due to Candida albicans after undergoing coronary artery bypass grafting (CABG) and were assessed. Six had sternal osteomyelitis, 1 had osteomyelitis and mediastinitis, and 4 had deep wound infections that probably involved bone. Seven patients experienced onset of infection within 28 days of CABG, but 4 experienced onset 48-150 days after CABG. Infections were characterized by a chronic, indolent course requiring prolonged treatment with an antifungal agent. Delay in initiating antifungal therapy was common. All patients were treated with fluconazole, and 1 also received amphotericin B. Six patients underwent incision and drainage, with or without wire removal, and 3 underwent sternectomy with placement of a muscle flap. Of 10 patients for whom follow-up data were available, 7 were cured after initial therapy (median duration of treatment, 6 months), and 3 experienced a relapse and required a second course of fluconazole.
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Candida mediastinitis may be treated successfully with surgical debridement followed by either amphotericin B or fluconazole therapy.
“On the basis of a small number of cases, Candida mediastinitis may be treated successfully with surgical debridement followed by either amphotericin B or fluconazole therapy [185, 199] (III-C).”
From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [185]
The presentation of candidal mediastinitis may be indolent and delayed.
“The presentation of candidal mediastinitis may be indolent and delayed [185].”
From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [185]
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- Authors
- Malani, P. N., McNeil, S. A., Bradley, S. F., & Kauffman, C. A.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Kauffman, Carol A.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2002-12
- Volume
- 35
- Issue
- 11
- Pages
- 1316-1320
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2117119663
- Cited by
- 62
- References
- 21
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 7 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 4 · 2015: 3 · 2013: 1 · 2012: 7
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Surgery › Orthopedic Infections and Treatments
- Health Sciences › Medicine › Surgery › Infectious Aortic and Vascular Conditions
- Keywords
- Candida albicans, sternal wound infection, median sternotomy, coronary artery bypass grafting, sternal osteomyelitis, mediastinitis, antifungal therapy, fluconazole, amphotericin B, treatment delay, relapse, sternectomy, muscle flap, incision and drainage
- MeSH terms
- Aged, Antifungal Agents, Coronary Artery Bypass, Candida albicans, Candidiasis, Chronic Disease, Female, Humans, Male, Middle Aged, Postoperative Complications, Recurrence, Sternum, Wound Infection, Treatment Outcome
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