A case of postoperative wound infection caused by Mycobacterium wolinskyi

Abstract

A 69-year-old woman underwent a total hysterectomy for uterine cancer and was undergoing postoperative chemotherapy. One month after surgery, the patient developed a postoperative wound infection caused by methicillin-sensitive Staphylococcus aureus (MSSA) in her midline abdominal postoperative wound and was treated with antimicrobial agents. Three months after surgery, a fistula and serous exudate appeared in her midline abdominal postoperative wound and the patient was treated with oral minocycline and topical sodium fusidic acid ointment. Two weeks after starting treatment, exudate culture specimens were collected and a rapidly growing mycobacterium was detected, but its name could not be identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. The rapidly growing mycobacterium detected was identified as Mycobacterium wolinskyi by analyses of the rpoB and hsp65 gene sequences. Based on the susceptibility, the patient was treated with minocycline and moxifloxacin for approximately 4 months, and her symptoms improved. In postoperative wound infections which do not respond well to treatment targeting common bacteria, it is important to include nontuberculous mycobacterium as a causative organism and to perform appropriate culture tests.