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Tracheocarotid artery fistula infected with methicillinresistant Staphylococcus aureus

  • M. F. Tungekar (a1)

Abstract

Massive life-threatening haemorrhage from a fistula between the trachea and a major blood vessel of the neck is a rare complication of the tracheostomy procedure, well-recognized by anaesthetists and otolaryngologists. Although the lesion is likely to be encountered at autopsy, it is not described in histopathological literature. The possible causes are discussed together with the macroscopic and microscopic appearances of the lesion. Suitable procedures for its identification and for obtaining appropriate histopathological blocks are suggested. Presence of methicillin-resistant Staphylococcus aureus (MRSA) has not been documented before and might have contributed to the genesis of the fistula in this case.

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Copyright

Corresponding author

Address for correspondence: Dr M. F. Tungekar, Histopathology Department, Second Floor, North Wing, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH

References

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Billy, M. L., Snow, N. J., Haug, R. H. (1994) Tracheocarotid fistula with life-threatening hemorrhage: report of case. Journal of Oral and Maxillofacial Surgery 52: 13311334.
Carson, L., Stransky, R. (1994) A 75-year-old woman with tracheostomy site bleeding. Journal of Emergency Nursing 20: 7980.
Humphreys, H., Duckworth, G. (1997) Methicillin-resistant Staphylococcus aureus (MRSA) – a reappraisal of control measures in the light of changing circumstances. [Review]. Journal of Hospital Infection 36: 167170.
Jones, J. W., Reynolds, M., Hewitt, R. L., Drapanas, T. (1976) Tracheo-innominate artery erosion: Successful surgical management of a devastating complication. Annals of Surgery 184: 194204.
Keceligil, H. T., Erk, M. K., Kolbakir, F., Yildirim, A., Yilman, M., Unal, R. (1995) Tracheoinnominate artery fistula following tracheostomy. Cardiovascular Surgery 3: 509510.
Wright, C. D. (1996) Management of tracheoinnominate artery fistula. [Review]. Chest Surgery Clinics of North America 6: 865873.

Keywords

Tracheocarotid artery fistula infected with methicillinresistant Staphylococcus aureus

  • M. F. Tungekar (a1)

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