What are the surgical options for Pseudomonas infections?

Updated: Dec 17, 2018
  • Author: Selina SP Chen, MD, MPH; Chief Editor: Russell W Steele, MD  more...
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Answer

See the list below:

  • Brain abscesses usually require surgical drainage, followed by a prolonged course of antibiotic therapy.

  • Sternoarticular pyarthrosis often requires surgical debridement.

  • Patients with osteochondritis or chronic contiguous osteomyelitis require surgical debridement of necrotic bone, foreign bodies, or possible prosthetic materials.

  • Tympanomastoid surgery is no longer considered standard management for chronic suppurative otitis media, unless a cholesteatoma is present.

  • Patients with malignant externa otitis usually require surgical treatment (eg, ear canal debridement, bone or cartilage debridement, mastoidectomy, facial nerve decompression).

  • Surgical intervention is indicated for bowel necrosis, perforation, obstruction, or undrained pus, although intervention for anorectal infections of patients with malignancies and neutropenia is controversial.

  • Patients with endocarditis require aggressive antibiotic therapy and surgery. If bacteremia persists 2 weeks after antimicrobial therapy, a valvulectomy is indicated. Patients with left-sided endocarditis that is refractory to antibiotic treatment and is hemodynamically unstable require early valve replacement.

  • Bilateral lung and heart-lung transplants are options offering moderate success rates for children and young adults in whom end-stage CF lung disease is associated with chronic pseudomonal lower respiratory tract infections.

  • Over-the-counter topical antiseptic drugs for use prior to surgery or injections have reported outcomes that range from localized infections at injection sites to systemic infections that resulted in death. Organisms implicated in the outbreaks included P aeruginosa. The FDA recommends single-use packaging and to follow label instructions to reduce the number of bacteria on the skin.


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