Delayed sternal Mycobacterium tuberculosis infection after left ventricular assist device implantation: A case report

Int J Artif Organs. 2024 Mar;47(3):217-222. doi: 10.1177/03913988241229957. Epub 2024 Feb 16.

Abstract

The incidence of Mycobacterium tuberculosis (Mtb) infection in patients with mechanical circulatory support devices is extremely rare. We present a case involving a 38-year-old male who experienced a delayed sternal Mtb infection following left ventricular assist device (LVAD) implantation. More than 5 months post-surgery, the patient was readmitted to the hospital presenting a subxiphoid abscess. The incision site displayed an unsatisfactory healing process after the incision and drainage of the abscess. Despite engaging in a rigorous treatment protocol, which included anti-infective therapy, vacuum-assisted closure, and surgical debridement, the patient's wound remained unhealed. Ultimately, after pus gene sequencing confirmed the diagnosis, the patient was administered a regimen combining anti-tuberculosis and anti-infective therapy, which culminated in the successful healing of the wound. This singular case study not only reveals the clinical progression of an unexpected Mtb infection post-implantation but also emphasizes the challenges encountered in diagnosis and management.

Keywords: Left ventricular assist device; Mycobacterium tuberculosis; infection; sternal tuberculosis.

Publication types

  • Case Reports

MeSH terms

  • Abscess
  • Adult
  • Heart Failure* / surgery
  • Heart-Assist Devices*
  • Humans
  • Male
  • Sternum / surgery
  • Treatment Outcome
  • Tuberculosis*
  • Wound Healing