An Interesting Case of a Nonhealing Obstetric Surgical Site Infection of a Concomitant Rare Fungal and Tuberculous Origin

Abstract

Aim:To understand an algorithmic approach toward a nonhealing surgical site infection (SSI) and broaden our diagnostic outlook toward its uncommon infective etiologies. Background: Nonhealing wound causes significant morbidity and mortality of patients. One of the rare causes behind nonhealing wound infection is Mycobacterium tuberculosis which often remains undiagnosed and increases financial, psychological, and physical burden of the patient and hospital. Case description: Twenty-five-year-old female with a refractory nonhealing lower segment cesarean section wound infection which did not respond to higher antibiotics was later found to be of tubercular and fungal etiology. Conclusion:Optimal involvement of a multidisciplinary team and a precise diagnostic algorithmic approach to treat a refractory SSI with a high degree of suspicion for unusual causes of refractory SSI. Clinical significance: This case report recommends having high degree of clinical suspicion of wound tuberculosis and concomitant infections and sending wound biopsies in all the patients with delayed/nonhealing at earliest.