case_images: PMC9637885_01
case_images: Intraoperative photographs showing irrigation and debridement (ID) of sternal wound (left) and the open sinus following ID and removal of infected cartilage and sternum (right).
case_images: gr1.jpg
case_images: PMC9637885_01_gr1.jpg
case_images: fig0005
case_images: He underwent irrigation and debridement, inferior sternectomy, and removal of wires (Fig. 1).
case_images: Complete left costal cartilage "cast" displaying chronic destruction.
case_images: gr2.jpg
case_images: PMC9637885_01_gr2.jpg
case_images: fig0010
case_images: The left cartilage segments for ribs four through seven were removed in complete "casts" with evidence of cobblestoning and chronic destruction (Fig. 2).
case_images: Histopathology of removed costal cartilage displaying acute angle branching, narrow, septate hyphae of Aspergillus fumigatus (10x left and 50x right; Grocott-Gomori's methenamine silver stain).
case_images: gr3.jpg
case_images: PMC9637885_01_gr3.jpg
case_images: fig0015
case_images: Silver displayed acute-angle branching septate hyphae (Fig. 3). Susceptibility testing for Aspergillus was not available at the institution that this case took place, so voriconazole was chosen as empiric therapy.