{"pk":7948,"title":"Delayed Presentation of Deep Sternal Wound Infection","subtitle":null,"abstract":"Deep sternal wound infections (DSWI) are infections of the sternum, mediastinum, or the muscle, fascia and soft tissue that overlie the sternum, typically occurring within a month of cardiac surgery.  They are infrequent though severe complications of cardiac surgery. Diagnosis is made by the clinical presentation of fever, chest pain, or sternal instability in the setting of wound drainage, positive wound cultures, or chest radiographic findings.  We describe the case of an elderly man presenting 6 months after cardiac surgery with DSWI. Due to the atypical nature of such a late presentation, definitive therapy was delayed. Given a severely ill patient with multiple risk factors for poor wound healing, the clinician must maintain a high index of suspicion for DSWI despite a delayed presentation. [West J Emerg Med. 2014;15(2):134–136.]","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"sepsis, sternotomy, mediastinitis"}],"section":"Diagnostic Acumen","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6zr9g7jc","frozenauthors":[{"first_name":"Linda","middle_name":"","last_name":"Joseph","name_suffix":"","institution":"St. Luke’s University Hospital and Health Network, Bethlehem, Pennsylvania","department":"None"},{"first_name":"Rebecca","middle_name":"K.","last_name":"Jeanmonod","name_suffix":"","institution":"St. Luke’s University Hospital and Health Network, Bethlehem, Pennsylvania","department":"None"}],"date_submitted":"2013-08-22T01:28:27Z","date_accepted":"2013-08-22T01:28:27Z","date_published":"2014-03-19T21:10:16Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/7948/galley/4608/download/"}]}