[A case report of mediastinitis due to methicillin resistant Staphylococcus aureus after total aortic arch replacement].

A 78-year-old man underwent total aortic arch replacement for ruptured aortic arch aneurysm. Two weeks after the surgery, high fever and leucocytosis developed. He was placed on a regimen of antibiotics. However, mediastinitis eventually ensued five weeks later with the pus draining from the sternotomy wound. The culture revealed a Methicillin resistant staphylococcus aureus. The infected tissue was debrided from the mediastinal cavity 40 days postoperatively. The cavity was kept open and was intermittently irrigated with 2% Providone-iodine for three days. Subsequently, an omental graft was placed. The infection successfully subsided gradually and the patient has been well for a year and a half after the initial surgery. The procedure is considered to be extremely effective for the management of a drastic infection involving thoracic aortic prosthesis.