title: Severe intra-abdominal infection due to Streptococcus Milleri following adjustable gastric banding.
abstract: 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.
authors.affiliation: Department of General and Transplant Surgery, University Hospital of Innsbruck, Austria.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Stelzmueller
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hoeller
authors.forename: Silke
authors.initials: S
authors.lastname: Wiesmayr
authors.forename: Reinhold
authors.initials: R
authors.lastname: Kafka
authors.forename: Franz
authors.initials: F
authors.lastname: Aigner
authors.forename: Helmut
authors.initials: H
authors.lastname: Weiss
authors.forename: Hugo
authors.initials: H
authors.lastname: Bonatti
mesh_terms: 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
chemical_list: D010397:Penicillanic Acid; D000078142:Tazobactam; D010878:Piperacillin