Mesh infection of Mycobacterium fortuitum after inguinal hernia repair: A rare case report and literature review

Abstract

PURPOSE: Inguinal hernia repair is one of the most common operations worldwide. The standard procedure now is tension-free hernioplasty with mesh implantation. Mesh repairs obviously reduce the rate of hernia recurrence and alleviate the pain. However, mesh infection is one of the most serious complications, which usually causes secondary operation. At present, no standard treatment measures of mesh infections, especially for rare pathogens such as nontuberculous mycobacteria (NTM), are available. MATERIALS AND METHODS: We present an unusual case of Mycobacterium fortuitum infection of implanted mesh after inguinal hernia repair. Medline and PubMed databases were searched using the keywords mentioned subsequently, and the literature on treatment measures of mesh infection of M. fortuitum and other subtypes of NTM after inguinal hernia repair is reviewed. RESULTS: Mesh infections of M. fortuitum are very rare after inguinal hernia repair. The infection is hard to diagnose and complex to treat. However, it has characteristic clinical manifestations. With early recognition and specific tests, clinicians can still confirm the infection. Treatments include antibiotics and surgical intervention. Mesh displantation is considered to be necessary and needs to be conducted as soon as possible. CONCLUSION: When a mesh infection is present, it is important to check the wound before obtaining bacteriological evidence. Once the mycobacteria infection is suspected, corresponding tests should be taken immediately. With appropriate treatment, patients will likely make a full recovery.