Nontuberculous Mycobacterial Infection After Cholecystectomy: A Case Series and Literature Review

Abstract

Nontuberculous mycobacteria (NTM) are ubiquitous micro-organisms that can cause skin, soft tissue, and respiratory infections. Some of these bacteria are resistant to the commonly used disinfectants in hospitals and lead to wound infections after surgery. The diagnosis of NTM infections requires a high index of clinical suspicion as their clinical presentation often overlaps with other bacterial infections. Moreover, the isolation of NTM from clinical samples is difficult and time-consuming. Also, there is a lack of standardized treatment protocols for NTM infections. We report four cases of delayed wound infections after cholecystectomy probably due to NTM which were successfully treated by a combination of clarithromycin, ciprofloxacin, and amikacin.

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“…Singh et al, in her series of four cases of NTM infections following laparoscopic cholecystectomy reported delayed onset of appearance of discharging sinuses with surrounding discoloration. 25 Long standing treatment using second-line ATT drugs was used for 4-10 months period. Author also highlighted role of high clinical suspicion to start treatment as cultures are often negative.…”