Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Bures, C; Zielinski, V; Klatte, T; Swietek, N; Kober, F; Tatzgern, E; Bobak-Wieser, R; Gschwandtner, E; Gilhofer, M; Wechsler-Fördös, A; Hermann, M.
Streptococcal mediastinitis after thyroidectomy. A literature review].
Chirurg. 2015; 86(12):1145-1150
Doi: 10.1007/s00104-014-2972-y
(- Case Report)
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- Gschwandtner Elisabeth
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- Abstract:
- Surgical site infections after thyroid surgery are mostly superficial and can be well treated. Streptococcal mediastinitis in contrast is a rare but life-threatening complication. A 57-year-old female patient experienced septic fever, increase of inflammation parameters and erythema 2 days after thyroid surgery for Graves' disease. This process was triggered by a three-compartment infection by group A Streptococcus (GAS) with involvement of the mediastinum. Therapy over 6 weeks including seven wound revisions with the patient under general anesthesia, pathogen-adapted antibiotic treatment and cervical negative pressure treatment managed to control the infection. A total of 21 cases have been published on this phenomenon, 11 of which had a fatal outcome. High fever and surgical site erythema in the early postoperative period after thyroid surgery can be signs of a GAS infection, which might lead to necrotizing, descending, life-threatening mediastinitis. Early diagnosis with support of computed tomography (CT) scans, immediate therapy including wound opening, lavage, intravenous antibiotic treatment with penicillin and clindamycin are vital. If treatment resistance occurs, cervical negative pressure treatment should be considered.
- Find related publications in this database (using NLM MeSH Indexing)
- Combined Modality Therapy -
- Female -
- Graves Disease - surgery
- Humans -
- Mediastinitis - etiology
- Mediastinitis - therapy
- Middle Aged -
- Streptococcal Infections - etiology
- Streptococcal Infections - therapy
- Streptococcus pyogenes -
- Surgical Wound Infection - etiology
- Surgical Wound Infection - therapy
- Thyroidectomy -
- Find related publications in this database (Keywords)
- Streptococcus
- Mediastinitis
- Thyroidectomy
- Negative pressure therapy
- Antibiotics