Serratia marcescens thigh infection after transobturator sling without associated mesh exposure

Soft tissue complications of the thigh occur after transobturator slings and are reported to uniformly accompany mesh exposure. Most commonly identified microorganisms cultured from such soft tissue infections include Bacteroides and Streptococcus species. This is the first reported case of Serratia marcescens leading to thigh cellulitis after a transobturator sling and the complication occurred in the absence of exposed mesh.

A 54-year-old presented 7 days after a transobturator sling with right thigh cellulitis and sepsis in the absence of mesh exposure. She underwent explantation of the sling and incision and drainage of the groin incision. Cultures grew S. marcescens.

Soft tissue infections of the thigh after transobturator tape are rare, but commonly associated with exposed mesh. Mesh exposure does not lead to thigh complications uniformly. The fact that this patient had no exposed mesh poses several questions about the pathogenesis of soft tissue infections of the thigh after transobturator slings.