What is the role of surgery in the treatment of mycobacterium chelonae infection?

Updated: Dec 20, 2018
  • Author: Alfred Scott Lea, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Aggressive debridement of infected soft tissue has always been advocated as a modality of therapy. Uncomplicated infections may not require surgical intervention, and it is not unusual for practitioners to try antimicrobial chemotherapy alone before undertaking a surgical procedure. Excision and debridement is currently recommended when infection is extensive, recurrent, or drug resistant. Abscess formation with or without sinus tract formation and bone involvement usually requires formal debridement. [25, 29] In addition, infections in patients intolerant of drug therapy may need surgical excision.

Any infected foreign body or implanted device usually must be removed in combination with antibiotic therapy to optimize the therapeutic outcome. [18, 20, 21, 27, 29]

Ocular infections usually require surgical intervention. [23]

Pulmonary infection only requires surgical intervention when it is extensive, cavitary, or nonresponsive to drug therapy. Surgery usually involves lobectomy or segmentectomy and has been reported to have acceptable morbidity and mortality in most cases with reasonable preserved lung function. [37]


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