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Post-Sternotomy Mediastinitis — SCE Infectious Diseases MCQ

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ModerateHealthcare-Associated InfectionsPost-Sternotomy MediastinitisSCE Infectious Diseases

A 70-year-old man develops a wound infection following coronary artery bypass grafting. The sternal wound is dehisced with exposed sternal wires and purulent drainage. Deep tissue cultures grow Staphylococcus aureus (MSSA). What is the medical term for this complication?

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Correct answer: E — Post-sternotomy mediastinitis

Deep sternal wound infection with sternal dehiscence and purulent drainage reaching the mediastinal space constitutes post-sternotomy mediastinitis — a serious complication occurring in 1–5% of cardiac surgery cases. It carries mortality of 10–25%. Management requires surgical debridement (sternal rewiring or muscle flap reconstruction) plus prolonged IV antibiotics (typically 4–6 weeks of IV Flucloxacillin for MSSA). Vacuum-assisted closure (VAC) therapy may bridge to definitive reconstruction.

Reference: NICE NG125 2020 – Surgical site infections; ESC 2023 – Post-cardiac surgery infections