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Indian Journal of Surgery, Vol. 67, No. 3, May-June, 2005, pp. 167-168 Letter To Editor Port-site tuberculosis after laparoscopic cholecystectomy Stephen E, Lee AD, Agarwal S Department of General Surgery, Christian Medical College
Hospital, Vellore, Tamil Nadu Code Number: is05050 Dear Editor, We have read with interest, the article on Port-site tuberculosis by Tauro et al.[1] As a tertiary care referral center, we have seen this complication after laparoscopic cholecystectomy on a fairly regular basis,[2] which in itself is a cause for concern. Invariably, these port-site infections are due to atypical mycobacteria from improperly sterilized laparoscopic equipment. We have not seen any case of Mycobacterium tuberculosis isolated from these infections. This brings us to a couple of questions/comments to the authors 1. Was tissue sent for routine and atypical mycobacterial cultures? Infections caused by M. tuberculosis and atypical mycobacteria are indistinguishable histopathologically, and it is erroneous to assume M. tuberculosis infection on the sole basis of a histopathology report. Culture with appropriate sensitivity testing is the only way to make a correct diagnosis and treat the condition. 2. Although this patient has remained asymptomatic after the wide debridement and conventional anti-tubercular therapy, if this is an atypical mycobacterial infection, there is a definite chance of late recurrence. In case of a recurrence, the patient will need a repeat wide debridement and prolonged course of antibiotics like amikacin and ofloxacin, and not conventional anti-tubercular therapy. References
Copyright 2005 - Indian Journal of Surgery |
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