Anaerobic mediastinitis complicating median sternotomy

Prostatic abscess associated with Bacteroides fragilis mediastinitis after heart surgery

Anaerobic mediastinitis after cardiac surgery is a rare and poorly understood condition. We observed a patient with diabetes and myelodysplastic syndrome who developed Bacteroides fragilis mediastinitis in conjunction with a prostatic abscess, several days after coronary artery bypass surgery; this hitherto unpublished observation suggests that suppurative infection of the genito-urinary tract may constitute a portal of entry for postoperative anaerobic mediastinitis in predisposed patients.

Postoperative mediastinitis due to Finegoldia magna with negative blood cultures

We report a case of Finegoldia magna (formerly known as Peptostreptococcus magnus) mediastinitis following coronary artery bypass in a 50-year-old patient. Even if staphylococci remain the main causative organism of postoperative mediastinitis, the responsibility of anaerobic bacteria must be considered in cases of fever and sternal drainage with negative blood cultures.

Significant decrease of gram-negative anaerobic bacteremia in a major hospital from 1967-73 to 1981-89: an effect of the introduction of metronidazole?

Declining rates of anaerobic bacteremia are reported from medical centres all over the world. At Odense University Hospital the frequency of Gram-negative anaerobic bacteremia decreased from 1.62% in 1967-73 to 0.83% in 1981-89 (p < 0.001). Metronidazole prophylaxis prior to bowel surgery seems to be the most important explanation, as the association of Bacteroides bacteremia with surgery decreased from 80% to 48% (p < 0.01) and no cases of Bacteroides bacteremia occurred during metronidazole treatment without the presence of abscess or gangrene. A contributory factor may be improved methods for abscess localization and drainage. Other drugs having an effect on anaerobes seem of minor importance. A new category of patients seems to be those who have undergone aorto-femoral bypass operation for aneurysm of the aorta. They contract anaerobic Gram-negative bacteremia from infected hematomas or intestinal gangrene.