Postoperative mediastinitis after cardiac surgery caused by Mycoplasma hominis: a case report

Abstract Background Mycoplasma hominis is a human commensal bacterium of the urogenital tract, and extragenital infection caused by M. hominis has rarely been reported. The identification of M. hominis is challenging, and surgeons are generally not aware that this bacteria can cause postoperative in...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Hiroki Kitagawa, Haruna Shimizu, Keijiro Katayama, Kayoko Tadera, Toshihito Nomura, Kietaro Omori, Norifumi Shigemoto, Taiichi Takasaki, Hiroki Ohge, Shinya Takahashi
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Mycoplasma hominis Postoperative infections Cardiovascular surgery Molecular identification MALDI-TOF MS Surgery RD1-811
Acceso en línea:	https://doaj.org/article/e5a73ed5cdbc4b7f8aa4f010ed74a196
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:e5a73ed5cdbc4b7f8aa4f010ed74a196
record_format	dspace
spelling	oai:doaj.org-article:e5a73ed5cdbc4b7f8aa4f010ed74a1962021-11-28T12:29:07ZPostoperative mediastinitis after cardiac surgery caused by Mycoplasma hominis: a case report10.1186/s40792-021-01326-02198-7793https://doaj.org/article/e5a73ed5cdbc4b7f8aa4f010ed74a1962021-11-01T00:00:00Zhttps://doi.org/10.1186/s40792-021-01326-0https://doaj.org/toc/2198-7793Abstract Background Mycoplasma hominis is a human commensal bacterium of the urogenital tract, and extragenital infection caused by M. hominis has rarely been reported. The identification of M. hominis is challenging, and surgeons are generally not aware that this bacteria can cause postoperative infection. Here, we report a rare case of postoperative mediastinitis caused by M. hominis after cardiac surgery in an immunocompetent patient. Case presentation A 54-year-old man presented with pain and purulent discharge from the wound after aortic valve replacement and patent foramen ovale closure. However, Gram staining and culture of bacteria from the purulent discharge was negative, and empiric sulbactam/ampicillin therapy was not effective. This patient developed mediastinitis and rupture of a pseudoaneurysm of the ascending aorta caused by mediastinitis, and re-operation was performed. Then, postoperative mediastinitis caused by M. hominis or Ureaplasma species was suspected and bacterial cultures targeting these pathogens were performed. M. hominis was identified from abscess and tissue obtained from the surgical site and urine. A final diagnosis of postoperative mediastinitis caused by M. hominis was determined. The patient was initially treated with levofloxacin and then with minocycline for 3 weeks. The patient’s clinical condition improved; the patient was transferred to another hospital. Conclusion The role of M. hominis as a cause of postoperative infection might be underestimated in cardiac surgery. M. hominis should be considered when culture-negative purulent discharge is observed or there is no response to standard empiric treatment of postoperative infections.Hiroki KitagawaHaruna ShimizuKeijiro KatayamaKayoko TaderaToshihito NomuraKietaro OmoriNorifumi ShigemotoTaiichi TakasakiHiroki OhgeShinya TakahashiSpringerOpenarticleMycoplasma hominisPostoperative infectionsCardiovascular surgeryMolecular identificationMALDI-TOF MSSurgeryRD1-811ENSurgical Case Reports, Vol 7, Iss 1, Pp 1-5 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Mycoplasma hominis Postoperative infections Cardiovascular surgery Molecular identification MALDI-TOF MS Surgery RD1-811
spellingShingle	Mycoplasma hominis Postoperative infections Cardiovascular surgery Molecular identification MALDI-TOF MS Surgery RD1-811 Hiroki Kitagawa Haruna Shimizu Keijiro Katayama Kayoko Tadera Toshihito Nomura Kietaro Omori Norifumi Shigemoto Taiichi Takasaki Hiroki Ohge Shinya Takahashi Postoperative mediastinitis after cardiac surgery caused by Mycoplasma hominis: a case report
description	Abstract Background Mycoplasma hominis is a human commensal bacterium of the urogenital tract, and extragenital infection caused by M. hominis has rarely been reported. The identification of M. hominis is challenging, and surgeons are generally not aware that this bacteria can cause postoperative infection. Here, we report a rare case of postoperative mediastinitis caused by M. hominis after cardiac surgery in an immunocompetent patient. Case presentation A 54-year-old man presented with pain and purulent discharge from the wound after aortic valve replacement and patent foramen ovale closure. However, Gram staining and culture of bacteria from the purulent discharge was negative, and empiric sulbactam/ampicillin therapy was not effective. This patient developed mediastinitis and rupture of a pseudoaneurysm of the ascending aorta caused by mediastinitis, and re-operation was performed. Then, postoperative mediastinitis caused by M. hominis or Ureaplasma species was suspected and bacterial cultures targeting these pathogens were performed. M. hominis was identified from abscess and tissue obtained from the surgical site and urine. A final diagnosis of postoperative mediastinitis caused by M. hominis was determined. The patient was initially treated with levofloxacin and then with minocycline for 3 weeks. The patient’s clinical condition improved; the patient was transferred to another hospital. Conclusion The role of M. hominis as a cause of postoperative infection might be underestimated in cardiac surgery. M. hominis should be considered when culture-negative purulent discharge is observed or there is no response to standard empiric treatment of postoperative infections.
format	article
author	Hiroki Kitagawa Haruna Shimizu Keijiro Katayama Kayoko Tadera Toshihito Nomura Kietaro Omori Norifumi Shigemoto Taiichi Takasaki Hiroki Ohge Shinya Takahashi
author_facet	Hiroki Kitagawa Haruna Shimizu Keijiro Katayama Kayoko Tadera Toshihito Nomura Kietaro Omori Norifumi Shigemoto Taiichi Takasaki Hiroki Ohge Shinya Takahashi
author_sort	Hiroki Kitagawa
title	Postoperative mediastinitis after cardiac surgery caused by Mycoplasma hominis: a case report
title_short	Postoperative mediastinitis after cardiac surgery caused by Mycoplasma hominis: a case report
title_full	Postoperative mediastinitis after cardiac surgery caused by Mycoplasma hominis: a case report
title_fullStr	Postoperative mediastinitis after cardiac surgery caused by Mycoplasma hominis: a case report
title_full_unstemmed	Postoperative mediastinitis after cardiac surgery caused by Mycoplasma hominis: a case report
title_sort	postoperative mediastinitis after cardiac surgery caused by mycoplasma hominis: a case report
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/e5a73ed5cdbc4b7f8aa4f010ed74a196
work_keys_str_mv	AT hirokikitagawa postoperativemediastinitisaftercardiacsurgerycausedbymycoplasmahominisacasereport AT harunashimizu postoperativemediastinitisaftercardiacsurgerycausedbymycoplasmahominisacasereport AT keijirokatayama postoperativemediastinitisaftercardiacsurgerycausedbymycoplasmahominisacasereport AT kayokotadera postoperativemediastinitisaftercardiacsurgerycausedbymycoplasmahominisacasereport AT toshihitonomura postoperativemediastinitisaftercardiacsurgerycausedbymycoplasmahominisacasereport AT kietaroomori postoperativemediastinitisaftercardiacsurgerycausedbymycoplasmahominisacasereport AT norifumishigemoto postoperativemediastinitisaftercardiacsurgerycausedbymycoplasmahominisacasereport AT taiichitakasaki postoperativemediastinitisaftercardiacsurgerycausedbymycoplasmahominisacasereport AT hirokiohge postoperativemediastinitisaftercardiacsurgerycausedbymycoplasmahominisacasereport AT shinyatakahashi postoperativemediastinitisaftercardiacsurgerycausedbymycoplasmahominisacasereport
_version_	1718407987378257920

Postoperative mediastinitis after cardiac surgery caused by Mycoplasma hominis: a case report

Ejemplares similares