Mycobacterium avium pelvic abscess with vaginocutaneous fistula after transobturatory sling surgery
DOI:
https://doi.org/10.11606/issn.1679-9836.v100i6p605-608Keywords:
Pelvic abscess, Mycobacteriosis, FistulaAbstract
This study presents a rare case of abscess associated with vaginocutaneous fistula due to atypical mycobacterial infection after sling surgery, which was successfully treated. Abscesses and fistulas are rare postoperative complications in treatment of stress urinary incontinence by transobturatory sling surgery, due to its high rate of positive outcomes in the treatment of urinary incontinence in women. These complications are considered to be related to the composition of the mesh and bacterial infection. We report a case of a 50-year-old patient who developed, in the 7th postoperative year of perineoplasty with sling placement, pelvic abscess and cutaneous fistula in the left thigh. Microbiological examination of the lesion revealed infection by Mycobacterium avium. Antibiotic therapy plus abscess drainage surgery and surgical correction of the fistulous pathway were the treatment of choice. During the surgery, a vaginal opening of the cutaneous fistula was evidenced, originating from the sling mesh, which was removed and later proved to be colonized by M. avium. The patient became asymptomatic after 1 year of postoperative follow-up.
Downloads
References
Chogtu B, Malik DV, Magazine R, Shenoy VP. Mycobacterium fortuitum Infection at Umbilical Hernioplasty Site. J Clin Diagn Res. 2017;11(9):OD01–2. doi: 10.7860/JCDR/2017/26618.10531.
Walang B, Rath S, Sharma S. Nontuberculous mycobacterial infection after frontalis sling surgery using silicone rod. J Ophthalmic Inflamm Infect. 2012;2(4):219–21. doi:10.1007/s12348-012-0073-y.
Davies BW, Bratton EM, Durairaj VD, Hink EM. Bilateral candida and atypical mycobacterial infection after frontalis sling suspension with silicone rod to correct congenital ptosis. Ophthal Plast Reconstr Surg. 2013;29(4):e111–3. doi: 10.1097/IOP.0b013e318281eb1f.
Karabulut A, Demitaş Ö, Gök S. A late complication of transobturator tape procedure: vaginocutaneous fistula formation with vaginal mesh erosion. Int Urogynecol J. 2014 Apr 14;25(4):559–61. doi: 10.1007/s00192-013-2193-9.
Ramakrishnan P, Bansal S, Deuri B, Subbiah R, Palanisamy S, Palanivelu PR, et al. A single-centre experience of relaparoscopy in complications of laparoscopic inguinal hernia repair-feasibility and outcomes. Surg Endosc. 2016 Jun 30;30(6):2308–14. doi: 10.1007/s00464-015-4387-3.
Abdallah A, Nisolle M, de Landsheere L. Vaginocutaneous fistula and buttock abscess formation 7 years after polypropylene transobturator tape insertion. J Gynecol Obstet Hum Reprod. 2017;46(1):103–5. doi: 10.1016/j.jogoh.2016.11.006.
Cho MK, Choi MY, Kim CH. A late complication developing 12 years after a transobturator tape procedure: vulvar abscess with vaginocutaneous fistula. J Obstet Gynaecol (Lahore). 2018;38(1):139–40. doi: 10.1080/01443615.2017.1326888.
Reisenauer C, Wietek BM. Vagina–hip fistula after tension-free transobturator tape placement. Int Urogynecol J. 2015;26(11):1713-4. doi: 10.1007/s00192-015-2726-5.
Kannaiyan K, Ragunathan L, Sakthivel S, Sasidar AR, Muralidaran, Venkatachalam GK. Surgical site infections due to rapidly growing mycobacteria in puducherry, India. J Clin Diagn Res. 2015;9(3):DC05-8. doi: 10.7860/JCDR/2015/10572.5638.
Madhusudhan NS, Malini A, Sangma MMB. A case of surgical site infection caused by Mycobacterium fortuitum, following herniorrhaphy. J Clin Diagn Res. 2016 Nov;10(11):DD01–2. doi: 10.7860/JCDR/2016/20045.8924.
Inderlied CB, Kemper CA, Bermudez LE. The Mycobacterium avium complex. Clin Microbiol Rev. 1993;6(3):266-310. doi: 10.1128/CMR.6.3.266.
Diaco ND, Strohdach B, Falkowski AL, Hainc N, Brunner P, Rutishauser J, et al. Psoas Abscess Due to Mycobacterium avium in A Patient with Chronic Lymphocytic Leukemia－Case Report and Review. J Clin Med. 2019;8(2):216. doi: 10.3390/jcm8020216.
Orme IM, Ordway DJ. Host Response to Nontuberculous Mycobacterial Infections of Current Clinical Importance. Infect Immun. 2014;82(9):3516–22. doi: 10.1128/IAI.01606-13.
Nishiuchi Y, Maekura R, Kitada S, Tamaru A, Taguri T, Kira Y, et al. The Recovery of Mycobacterium avium-intracellulare Complex (MAC) from the Residential Bathrooms of Patients with Pulmonary MAC. Clin Infect Dis. 2007;45(3):347–51. doi: 10.1086/519383.
Carrasco J, Soto L, Samalvides F, Asencios L, Quispe N, Valencia E. Mycobacterium avium lung infection in HIV/AIDS patient: first report in Peru. Rev Peru Med Exp Salud Publica. 2014;31(1):156–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24718542
Reddy VM. Mechanism of Mycobacterium avium complex pathogenesis. Front Biosci. 1998;3(4):d525-31. doi: 10.2741/a300.
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Ricardo Vieira Teles Filho, Guilherme de Matos Abe, Lucas Henrique Souza de Azevêdo, Gabriela Daldat
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
