These 3 images show non-union of the sternum post-aortic valve replacement as a result of local Aspergillus fumigatus infection. Underlying the sternum is some soft tissue which is presumptively also infection and in the most inferior image, the pericardium is also invoved.
The patient also is diabetic, with rhematoid arthritis and ulcerative colitis and occasionally receives a course of corticosteroids. The wound discharged pus which grew A. fumigatus. It was managed conservatively with itraconazole initally, with failure of therapy over 3 months.