Surgical site infection by Mycobacterium tuberculosis following caesarian section

Abstract

Surgical site infection by M. tuberculosis is uncommon and its diagnosis can be missed unless there is strong clinical suspicion coupled with laboratory confirmation. We report a case of primary tuberculous surgical site infection without any evidence of pulmonary, skeletal or gastrointestinal tuberculosis in an immunocompetent patient, presented as non healing discharging wound following lower uterine caesarean section (LUCS). This is the first case report of its kind from Bangladesh to the best of our knowledge. The case was diagnosed by detection of acid fast bacilli (AFB) in pus by Ziehl Neelsen staining and histological evidence of granulomatous lesion compatible with tuberculosis found in surgically excised granulation tissue. The patient was treated with 4 anti-tubercular drugs regimen for initial two months and responded well showing complete healing of her wound. The case is being reported primarily for its unusual site and rarity as Mycobacterial infection.