Kyobu geka. The Japanese journal of thoracic surgery
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Mediastinitis caused by MRSA (Methicillin-Resistant Staphylococcus aureus) remains an intractable infection producing high mortality even in these days of advanced chemotherapy. The authors report a case of mediastinitis due to MRSA complicated with acute renal failure following mitral valve replacement. The patient's mediastinum had been thoroughly cleaned with physiological saline solution with 0.2% povidone iodine, and underwent a chemotherapy regimen of mini-dose vancomycin. ⋯ Our patient's progress confirmed that when chemotherapy using vancomycin is administered in a patient whose condition is complicated with acute renal failure, closely monitoring the vancomycin serum concentration is essential. Intermittent mini-dose intravenous administration is sufficient to maintain an effective vancomycin serum concentration. In our case, vancomycin serum concentration measured before and at completion of dialysis revealed no appreciable decline.
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Case Reports
[A case of traumatic aneurysm of the thoracic aorta with severe chronic compression of the trachea].
A case of successfully treated traumatic aneurysm of the thoracic aorta with severe major air way compression was reported. A 38-year-old man, who had a history of blunt chest trauma in a traffic accident twenty years ago, complained of asthma-like coughing chest CT scan and angiogram showed a saccular aneurysm of desending aorta compressing the isthmus of the trachea and the esophagus severely. Resection of the aneurysm and prosthetic graft replacement was undertaken successfully with the aid of F-F bypass. The trachea and the esophagus were well decompressed and the patient recovered well with no complaints.