Candida mediastinitis is a rare complication of open heart surgery with high mortality and morbidity usually associated with C. albicans. We are reporting the case of a 57 year old male who after having a triple coronary artery bypass graft procedure, had mediastinitis caused by Candida famata, a yeast, that had only been reported once before as the causal agent of this condition. It is of vital importance, that future cases be reported, due to the fact that both reported cases have led to patient demise.
Background
The safe management of patients with COVID-19 has been a challenge during the current pandemic, leading to healthcare workers being disproportionately affected by the virus. In Costa Rica, 20% of all infections and 27% of all ICU cases during the initial weeks of the outbreak were healthcare workers. The existing recommendations and protocols on how to care for an infected patient that requires acute surgical management have been applied successfully in various scenarios. We look to describe the first case of a COVID-19 patient that required surgical management in Costa Rica and present a summary of the protection measures utilized in a tertiary care hospital.
Materials and methods
A review of literature utilizing Embase, Medline Complete and Google Scholar was performed. A surgical case report using the SCARE statement guidelines was drafted and a brief summary of the 54 items contained in the hospital’s COVID-19 surgical protocol is described.
Case presentation
We present the case of a 29 year old obese male who had acute appendicitis with perforation that contracted SARS-CoV-2 and became symptomatic at home on pod#3, who later required multiple surgeries to address an infected abdominal hematoma both while having an active COVID-19 infection and afterwards.
Conclusions
Safety measures for both staff and patients are of the utmost importance during the current coronavirus pandemic. Limitations in the availability of personal protection equipment as well a lack of knowledge and experience with handling surgical patients with this condition have led to various safety and attention protocols being drafted. The successful management of this patient is the first experience in Costa Rica on how to properly address staff safety during a surgical procedure. None of the workers involved in care of this patient were diagnosed with SARS-CoV-2.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.