Clinical Findings That May Suggest a Sternal Wound Infection Caused By an Opportunistic Fungus

 

Reasons to suspect an opportunistic fungus in a patient with a sternal wound infection:

(1) impaired host defenses (poorly controlled diabetes, immunosuppression, etc)

(2) progressive sternal wound with negative bacterial cultures

(3) failure to respond to broad-spectrum antibiotics

(4) pleuritis or mediastinitis with negative bacterial cultures

(5) epidemiologic evidence of environmental contamination with a fungus in the hospital

 

Once the diagnosis is considered then it can be made by:

(1) taking fungal cultures

(2) tissue biopsy from the edge of the sternal wound