Aspergillus chest wall osteomyelitis: Surgical and medical management

This case report details the case of a 62-year-old male diabetic patient with persistent chest wall osteomyelitis that developed after repeat coronary artery bypass grafting. The chronic infection was localized to the right anterior chest wall and was refractory to medical and surgical treatment which included long-term antibiotics, five separate intraoperative debridements and reconstruction with vascularized omentum over a 2 year period at outside institutions. Aggressive surgical debridement with flap reconstruction resulted in definitive management of the infected chest wall. The organism isolated from intraoperative cultures yielded Aspergillus fumigatus. The surgical management of osteomyelitis and costochondritis in this location is reviewed accompanied by a literature review on this rare cause of chronic chest wall infection. © Springer-Verlag 2004.