The Journal of Thoracic and Cardiovascular Surgery, Vol 76, 723-728, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Pseudomonas infection of the sternum and costal cartilages. Report of three cases
DR Miller, K Murphy and T Cesario
Pseudomonas osteochondritis of the chest wall and sternum has rarely been
reported, but when present it has been extremely difficult to eradicate.
Multiple operations to debride the involved areas and use of antibiotics
have often been inadequate to control this resistant infection. This report
describes our experience with three patients who had the late development
of Pseudomonas osteochondritis of the chest wall. The infection occurred
following crush trauma, sternotomy for congenital heart disease, and
mastectomy and amputation of the upper extremity for carcinoma of the
breast. Antibiotic therapy alone and with limited operations was
unsuccessful in controlling the infection in all three instances.
Eventually, each patient required extensive regional surgical removal of
involved bone and cartilage. Complete healing followed. Our experience
favors the early wide removal of bony and cartilaginous tissues in the
involved region with preoperative and postoperative coverage by appropriate
antibiotics. Operative management is detailed.
