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Nosocomial rapidly growing mycobacterial infections following laparoscopic surgery: CT imaging findings

  • Gastrointestinal
  • Published:
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Abstract

Objective

To identify the distribution and frequency of computed tomography (CT) findings in patients with nosocomial rapidly growing mycobacterial (RGM) infection after laparoscopic surgery.

Method

A descriptive retrospective study in patients with RGM infection after laparoscopic surgery who underwent CT imaging prior to initiation of therapy. The images were analyzed by two radiologists in consensus, who evaluated the skin/subcutaneous tissues, the abdominal wall, and intraperitoneal region separately. The patterns of involvement were tabulated as: densification, collections, nodules (≥1.0 cm), small nodules (<1.0 cm), pseudocavitated nodules, and small pseudocavitated nodules.

Results

Twenty-six patients met the established criteria. The subcutaneous findings were: densification (88.5 %), small nodules (61.5 %), small pseudocavitated nodules (23.1 %), nodules (38.5 %), pseudocavitated nodules (15.4 %), and collections (26.9 %). The findings in the abdominal wall were: densification (61.5 %), pseudocavitated nodules (3.8 %), and collections (15.4 %). The intraperitoneal findings were: densification (46.1 %), small nodules (42.3 %), nodules (15.4 %), and collections (11.5 %).

Conclusion

Subcutaneous CT findings in descending order of frequency were: densification, small nodules, nodules, small pseudocavitated nodules, pseudocavitated nodules, and collections. The musculo-fascial plane CT findings were: densification, collections, and pseudocavitated nodules. The intraperitoneal CT findings were: densification, small nodules, nodules, and collections.

Key Points:

• Rapidly growing mycobacterial infection may occur following laparoscopy.

• Post-laparoscopy mycobacterial infection CT findings are densification, collection, and nodules.

• Rapidly growing mycobacterial infection following laparoscopy may involve the peritoneal cavity.

• Post-laparoscopy rapidly growing mycobacterial intraperitoneal infection is not associated with ascites or lymphadenopathy.

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Abbreviations

CT:

Computed tomography

RGM:

Rapidly growing mycobacteria

AFB:

Acid-fast bacilli

CABG:

Coronary artery bypass graft

ANVISA:

Brazilian Health Surveillance Agency

GE:

Gastro-esophageal

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Acknowledgments

The scientific guarantor of this publication is Cláudio Campi de Castro (University of São Paulo Medical School). The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Raymundo Soares de Azevedo Neto (University of São Paulo) kindly provided statistical advice for this manuscript. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Cassiano Antonio de Moraes University Hospital, Av. Marechal Campos, 1468, Vitoria, ES, 29040-091, Brazil

    Richard Volpato

  2. Department of Radiology, University of São Paulo Medical School, Av. Dr. Arnaldo, 455, Cerqueira César, São Paulo, 01246-903, Brazil

    Claudio Campi de Castro

  3. Department of Internal Medicine, Cassiano Antonio de Moraes University Hospital, Núcleo de Doenças Infecciosas, Av. Marechal Campos, 1468, Vitória, ES, 29040-091, Brazil

    David Jamil Hadad

  4. Department of Diagnostic Radiology, Unit 1473, Laboratório de Patologia PAT, Rua Portinari,27, salas 101-104, Vitoria, ES, 29045-415, Brazil

    Flavya da Silva Souza Ribeiro

  5. Department of Diagnostic Radiology, Unit 1473, UNIMED Diagnóstico, Rua Misael Pedreira, 350, Vitoria, ES, 29052-270, Brazil

    Ezequiel Leal Filho

  6. Department of Diagnostic Radiology, Unit 1473, The University of Texas M D Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA

    Leonardo P. Marcal

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  1. Richard Volpato
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Correspondence to Richard Volpato.

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Volpato, R., de Castro, C.C., Hadad, D.J. et al. Nosocomial rapidly growing mycobacterial infections following laparoscopic surgery: CT imaging findings. Eur Radiol 25, 2797–2804 (2015). https://doi.org/10.1007/s00330-015-3674-7

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  • DOI: https://doi.org/10.1007/s00330-015-3674-7

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