Mediastinitis is a serious complication after cardiac surgery. While
bacteria are the more common pathogens, fungal infections are rare.
Post-operative Aspergillus mediastinitis is considered to be a
catastrophic infection, affecting patients with specific predisposing
factors undergoing cardiothoracic surgery. The patient outcome after
aspergillus mediastinitis is extremely poor despite antifungal therapy
and surgery. The diagnosis is usually delayed and relies on direct
visualization and culture. Clinical features of post-operative
Aspergillus mediastinitis could be minimal, underlining the necessity
for a low index of suspicion in cases of culture-negative mediastinitis.
Antifungal therapy including amphotericin B or voriconazole along with
surgical debridement forms the mainstay of treatment.