Cardiothoracic surgical site phaeohyphomycosis caused by Bipolaris mould, multiple US states, 2008-2013: a clinical description

Med Mycol. 2016 Mar;54(3):318-21. doi: 10.1093/mmy/myv101. Epub 2015 Dec 24.

Abstract

Bipolaris mould surgical site infections (SSIs) are exceedingly rare. We describe 21 cases of Bipolaris SSIs in pediatric and adult cardiothoracic surgery patients at ten hospitals in Texas, Arkansas, and Florida during 2008-2013. Median case-patient age was 55 years (range: 3 days-82 years), and 19 (90%) were male. Ten (48%) had coronary artery bypass or valve surgery, and seven (33%) had heart transplantation. Fifteen (71%) had more than one cardiothoracic procedure (median: 3, range: 1-11). Thirteen (62%) case-patients (all 5 pediatric patients, and 8 (50%) of 16 adult patients) had delayed sternal closure (chest closed >1 day [median = 8 days; range: 2-22] following the initial cardiothoracic procedure). Thirteen (62%) had mediastinitis. Median time from initial surgery to positive Bipolaris culture was 20 days (range: 6-497). Sixteen (76%) case-patients died.

Keywords: Bipolaris; cardiothoracic surgery; fungal; mould; phaeohyphomycosis; surgical site infections.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Arkansas / epidemiology
  • Ascomycota / isolation & purification*
  • Child
  • Child, Preschool
  • Female
  • Florida / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Phaeohyphomycosis / epidemiology
  • Phaeohyphomycosis / microbiology
  • Phaeohyphomycosis / pathology*
  • Sex Distribution
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / pathology*
  • Survival Analysis
  • Texas / epidemiology
  • Thoracic Surgical Procedures / adverse effects*
  • Young Adult