February 8, 2016 — The University of Iowa Hospital has sent letters warning 1,500 surgery patients that they may have been exposed to a dangerous bacteria from heater-cooler devices on heart-lung bypass machines.
One patient was diagnosed with an Non-Tuberculous Mycobacteria (NTM) infection after having cardiac surgery in 2012. NTM grows very slowly and it can take years before symptoms appear, which can delay diagnosis.
The hospital sent a letter to every heart surgery patient from the last four years, recommending that patients seek follow-up care if they have the following symptoms:
- Fever lasting more than one week
- Pain, redness, heat, or pus around the surgical incision
- Night sweats
- Joint pain
- Muscle pain
- Loss of energy
- Failure to gain weight or grow (in infants)
During heart, lung, and liver surgeries, heater-cooler devices are used to control the temperature of blood during cardiac bypass. NTM does not normally cause infections in people, but it can grow in the water used in heater-cooler devices and spray from the exhaust fan onto a patient.
In October 2015, the FDA issued a warning and said it had received 32 reports of infections since 2010.
Some experts say the reports are “probably just the tip of the iceberg.” The problem is that doctors do not normally screen for Mycobacterium and many patients receive post-operative care at local clinics.
The longer diagnosis is delayed, the higher the risk of complications. The mortality rate for NTM infections is approximately 50%. Even after the infection is correctly diagnosed, patients must take multiple drugs with serious side effects. Patients who have implants (heart valve, graft, etc.) must also undergo revision surgery.
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