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Ann Thorac Surg 1977;23:163-166
© 1977 The Society of Thoracic Surgeons

Articles

Candida albicans Infection of Sternum and Costal Cartilages: Combined Operative Treatment and Drug Therapy with 5-Fluorocytosine

Frank E. Thomas, Jr., M.D.*, Charles E. Martin, M.D., R. Darryl Fisher, M.D., Robert H. Alford, M.D.

Departments of Medicine and Cardiac and Thoracic Surgery, Veterans Administration Hospital and Vanderbilt University School of Medicine, Nashville, TN.

Accepted for publication May 10, 1976.

* Address reprint requests to Dr. Thomas, Medical Service, Veterans Administration Hospital, Nashville, TN 37203.

Two patients with candidal sternal osteomyelitis have been successfully treated by operative debridement and adjuvant drug therapy with 5-fluorocytosine. One patient had developed postoperative candidal wound infection after sternotomy, and the other acquired candidal sternal osteomyelitis following Candida fungemia. The diagnosis, suggested by culture, was confirmed by identification of Candida pseudohyphae in debrided tissue. Histological confirmation of candidal sternal osteomyelitis indicates the need for operative debridement and specific systemic antifungal therapy. The drug 5-fluorocytosine appears to provide effective oral therapy in this situation.




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