Failure to obtain microbiological culture and its consequence in a mesh-related infection.
This report describes a case of a delayed diagnosis of a late-onset mesh infection due to an unexpected enteric pathogen, Enterobacter cloacae. A 62-year-old woman with a history of prior incisional hernia repair with a prosthetic mesh presented to the emergency room with signs of an abscess with surrounding cellulitis of her abdomen over a year after her hernia repair. The patient manifested minimal response to 1 month of oral antibiotics. She underwent a complicated yet successful treatment course including surgical mesh removal (with a peri-operative complication), implantation of a biological mesh for the ventral hernia defect and ultimately, antibiotics tailored to the offending pathogen identified by postoperative culture of the infected mesh.
Department of Veterans Affairs, National Center for Patient Safety, Ann Arbor, Michigan, USA. Juliette.Slomka@va.gov
Juliette M
JM
Slomka
Scott
S
Laker
Pranatharthi
P
Chandrasekar
Douglas E
DE
Paull
D016972:Enterobacter cloacae / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000175:diagnosis* / Q000382:microbiology; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000382:microbiology; D013526:Surgical Mesh / Q000009:adverse effects*