Severe intra-abdominal infection due to Streptococcus Milleri following adjustable gastric banding.
BACKGROUND
Laparoscopic adjustable gastric banding represents a safe and effective bariatric surgical method. Nevertheless, complications such as intraabdominal infections are associated with high morbidity and mortality.


METHODS
A 50-year old morbidly obese female patient underwent adjustable gastric banding with the Swedish band (SAGB). After an uneventful postoperative follow-up of 2 years, she developed band infection due to colon microperforation during endoscopic polypectomy. As the causative microorgansim, Streptococcus Milleri was revealed. Band removal was required, and recovery was quite prolonged.


CONCLUSIONS
Intra-abdominal infection with Streptococcus Milleri can cause severe and life-threatening disease. Therefore, early diagnosis and surgical intervention combined with body weight adapted antibiotic therapy for a sufficiently long period of time seems necessary. In patients with intra-abdominal implanted devices such as the SAGB who undergo endoscopic polypectomy, antibiotic prophylaxis should therefore be considered.
Stelzmueller
Ingrid
I
Department of General and Transplant Surgery, University Hospital of Innsbruck, Austria.
Hoeller
Elisabeth
E
Wiesmayr
Silke
S
Kafka
Reinhold
R
Aigner
Franz
F
Weiss
Helmut
H
Bonatti
Hugo
H
D018784:Abdominal Abscess / Q000382:microbiology / Q000628:therapy*; D015992:Body Mass Index; D003131:Combined Modality Therapy; D020878:Device Removal; D004322:Drainage / Q000379:methods; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D015905:Gastric Balloon / Q000009:adverse effects*; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010878:Piperacillin / Q000008:administration & dosage; D011183:Postoperative Complications / Q000382:microbiology / Q000601:surgery; D012720:Severity of Illness Index; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy*; D034364:Streptococcus milleri Group / Q000302:isolation & purification*; D000078142:Tazobactam
D010397:Penicillanic Acid; D000078142:Tazobactam; D010878:Piperacillin