Abstract
BackgroundMycobacterium abscessus is a rapidly growing Mycobacterium that is a common water contaminant in the environment. We report a case of M. abscessus infection with band erosion following laparoscopic gastric banding.Case presentationA 34-year-old woman developed insidiously progressing abdominal distension over a period of 1 year associated with abdominal pain, fatigue, night sweating and anorexia 4 years after laparoscopic gastric banding for obesity. Investigation revealed significant ascites with caseating granuloma in peritoneal biopsies from which M. abscessus was isolated. Band erosion with infection and multiple abdominal adhesions were confirmed during laparoscopic removal of the gastric band. To the best of our knowledge, this is the first reported case of M. abscessus infection after laparoscopic gastric banding surgery. We discuss the possible sources of infection, its indolent presentation, and therapeutic challenges.ConclusionIt is important to consider environmentally acquired infection in patients with signs and symptoms of infection in the presence of surgical prosthesis.
Highlights
Mycobacterium abscessus is a rapidly growing Mycobacterium that is a common water contaminant in the environment
Clinical disease due to M. abscessus most often presents as chronic lung disease, or as skin, bone or soft-tissue infection following trauma [1,2,3]
Nosocomial infections associated with infected prostheses have been reported, such as otitis media following tympanostomy tube placement, peritoneal catheter-related peritonitis, infection after breast augmentation and septic arthritis with joint prosthesis [5,6,7,8], there are no reported cases associated with laparoscopic gastric banding devices
Summary
Mycobacterium abscessus is a rapidly growing Mycobacterium that is a common water contaminant. Infections with other mycobacteria other than tuberculosis (MOTT) have been reported after gastric banding [9-11]. This report describes a case of M. abscessus peritonitis in a patient with a history of laparoscopic gastric banding surgery. Her surgical history included laparoscopic gastric banding surgery for obesity (body mass index = 50; weight, 120 kg) 4 years earlier without complications. The patient had received normal saline injections through an injection port underneath the skin in the first 2 years after surgery to tighten the band. She had lost 50 kg since surgery. The patient began treatment for rapidly growing Mycobacterium infection with clarithromycin, rifampicin, moxifloxacin and ethambutol. ≥ 16 treatment supplemented with amikacin for the first 2 months, the patient had an excellent recovery and become completely asymptomatic
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