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Two Rare Cases of Mesh Infection Due to Mycobacterium abscessus Following Laparoscopic Inguinal Hernia Repair
Alexis A Heilman1, Wihan Du Plessis1, Edward P Dominguez1
1Department of General Surgery, Riverside Methodist Hospital, Columbus, Ohio, USA.
Background:
Mesh infections after laparoscopic inguinal hernia repair are rare, particularly those caused by Mycobacterium abscessus, a multi-drug-resistant nontuberculous mycobacterium.
Case Presentation:
We describe two cases of M. abscessus infection following total extraperitoneal inguinal hernia repairs. Both patients developed delayed groin pain and fluid collections. Cultures confirmed M. abscessus, requiring mesh explanation and prolonged multi-drug antibiotic therapy. Despite complications, both achieved infection resolution after approximately 12 months.
Discussion:
Investigation suggested contamination of laparoscopic instrument sheaths as the infection source, prompting changes in sterilization protocols. The pathogen's biofilm formation and resistance to sterilization contributed to persistence.
Conclusion:
Early recognition, mesh removal, and multi-disciplinary care are essential for successful management of M. abscessus mesh infections. Strict adherence to sterilization protocols is critical in preventing such rare but serious complications.
