How can I treat my nontuberculous mycobacterium infections?

Question

Hello doctor,

I am 30 years old and have been married for the last 3.5 years. One and a half years ago, I had a surgery to remove an ovarian cyst and a fibroid tumor from the uterus by laparoscopy. But, somehow, one incision area got infected, and I was on antibiotics for almost five months. Meantime, I relocated and the infection become worse for which I had to undergo another surgery to remove the abdominal abscess.

In a couple of months, I became quite well, but one sudden day pus came out from the same area along with pain. My surgeon said it was fine, as the pus was there during the healing period. But this gets worse, and the area again needs to be cleaned out through a minor surgery. I still have that area swollen with pain on the left abdomen, and hence recently went through another CT scan, and it seems that I am suspected of having nontuberculous mycobacterium infection on my abdominal wall.

My doctor wanted another round of surgery to clean up the wound, followed by prolonged antibiotics. Could you please guide me by letting me know if surgery is the only option, or if there are other ways that I can leverage and get cured? I do not want another surgery and am looking for alternative but effective solutions.

Please let me know if you require additional information.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

It is unfortunate that you have to undergo repeated surgeries due to the infection. A combined therapeutic approach, including surgical drainage, debridement, and prolonged treatment (more than three months) with combined antimicrobial agents, has been used in managing cases of atypical mycobacteria.

In some cases, based on clinical assessment, successful treatment requires aggressive debridement of all infected subcutaneous tissues and skin. Surgery does play a major role in these kinds of infections and may have to be repeated. I should be able to give you more input if I see the scans and reports.

Kindly revert with the same.

Take care.

Answer 2

Hi,

Welcome back to icliniq.com.

I have gone through the report (attachment removed to protect patient identity).

Their plan of action is perfectly alright. You would be started on an empirical antibiotic, and following debridement and culture, the appropriate antibiotic can be used.

It takes six to eight weeks usually for the culture to be reported. As I had already mentioned, you may require the antibiotic for three to six months. Hopefully, a proper complete debridement and specific bacterial antibiotic should control the infection.

Sadly, these kinds of infections, although very rare, can be quite troublesome and often recur even after proper treatment. We should do our best and hope for the best.

Take care.