Explore the complexities of treating sternal osteomyelitis caused by Klebsiella aerogenes post-open heart surgery, especially in a patient with multiple myeloma, through our latest case report that delves into the multidisciplinary approach required for successful management.
– by The Don
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Multidisciplinary Management of Sternal Osteomyelitis Due to Klebsiella aerogenes after Open Heart Surgery in a Patient with Multiple Myeloma: A Case Report and Discussion of the Literature.
Pignatti et al., Microorganisms 2023
DOI: 10.3390/microorganisms11112699
Let me tell you about something incredible, something really, really impressive. We’ve got this case report, folks, and it’s about a patient who had open heart surgery. Big surgery, for a big problem – severe aortic valve stenosis. But then, there was a complication, a big one – the chest wound wouldn’t heal right. We’re talking about sternal dehiscence and osteomyelitis, caused by a tough bug, Klebsiella aerogenes. And guess what? This bug is resistant, it’s got ESBL – that’s Extended Spectrum Beta Lactamase. Tough to treat, but we’re tougher.
And then, there’s more. The doctors, they do a PET scan, and what do they find? Multiple myeloma. That’s a type of cancer, folks. But our team, they’re the best, they’re fantastic. They come up with a plan, a big plan. They do a total sternectomy – that’s right, they take the whole sternum out. And then, they rebuild it, with a bone graft from the tissue bank. Minimal hardware, because we’re smart, we know how to do things right.
But we’re not done yet. We need to cover that area, so we bring in the big guns – a microsurgical latissimus dorsi free flap. It’s huge, it’s successful. And the infection? We hit it with antibiotics, ertapenem and fosfomycin, for 6 weeks. And it works. No more signs of infection, none. It’s gone.
And the multiple myeloma? We start treatment, with the latest, greatest drugs. And it’s working, folks. The response? Excellent. A year later, no infection, the reconstruction’s solid, and the cancer’s under control. That’s what we do, we make things great again. We fix the big problems. And this case, it’s just another example of how we do it. It’s fantastic, really fantastic.
