Mycobacterium Abscessus Infection Post Gastric Band Surgery: A Case Report

Purpose: To describe a patient with resistant Mycobacterium abscessus infection, discuss the clinical features and review treatment. Methods: Information and records were obtained on a 39 year old Hispanic male diagnosed with an abdominal abscess who initially presented to the emergency department with a two week history of fever and chills. He had been prescribed ciprofloxacin and flagyl two days prior to presentation. The patient had a significant past surgical history of laparoscopic adjustable gastric band surgery. Results: The gastric band had eroded through the stomach wall causing an intra-abdominal abscess. The band was completely removed and the abscess was drained. Cultures grew Mycobacterium abscessus. Antibiotic susceptibility testing revealed that it was only sensitive to clarithromycin. Conclusion: Patients that present with fever and chills not responsive to routine antibiotics should be tested for resistant bacteria, such as Mycobacterium abscessus. This is especially important in patients that have foreign bodies in their abdomen. Currently, there are no guidelines on treatment for resistant intra-abdominal infections. The plan is to have this patient on clarithromycin for at least one and a half years to prevent additional resistance.