william-shakespeare-62936_640…..on heaven and earth Horatio, than are dreamt of in your philosophy”….William Shakespeare

It’s true……despite a scientists desire to ‘know it all’ we always find ourselves wanting.   The latest unimagined issue was just reported in the WASHINGTON POST.

A rare infection is occurring in 1 in 1000 patients who had heart bypass surgery since 2012.   A indolent infection of tuberculosis variant (called nontuberculous mycobacterium …NTM) can occur around the heart, when  the germ is aerosolized during an open heart procedure.  The infection comes from a water reservoir used on the heart-lung bypass machine, when the water in this unit is vaporized and lands in the chest opening.   This reservoir apparently was contaminated with these germs when it was manufactured in the plant in Germany, and it is the source of this unusual and slow-growing infection.  Although it is not linked to deaths, it is being brought to doctor’s attention to consider this unusual possibility in bypass patients who have strange symptoms occurring late after surgery.

I doubt we will see any cases of this locally; none have occurred yet, but it’s possible.  Such an infection is strange and rare and is not even on the list of ‘imagined’ complications one would consider in advising someone about such a surgery….yet there it is.   As physicians, we always have to consider any and every possibility that can complicate a treatment, even those things that we’ve not yet dreamt of.