Local antituberculosis treatment in nonhealing chronic surgical site tuberculosis: A novel approach to cure nonhealing wound!

Tuberculosis most commonly affects the lungs and less than 20% of cases showed extrapulmonary involvement. Tuberculosis at the surgical site is described in the medical literature with very few cases of cesarean section at the incision site. Nonhealing surgical site ulcers secondary to tuberculosis...

Full description

Saved in:
Bibliographic Details
Main Authors: Shital Patil, Deepak Patil, Shubhangi Khule, Gajanan Gondhali
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-09-01
Series:Annals of Medical Science and Research
Subjects:
Online Access:https://journals.lww.com/10.4103/amsr.amsr_38_23
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849243089190780928
author Shital Patil
Deepak Patil
Shubhangi Khule
Gajanan Gondhali
author_facet Shital Patil
Deepak Patil
Shubhangi Khule
Gajanan Gondhali
author_sort Shital Patil
collection DOAJ
description Tuberculosis most commonly affects the lungs and less than 20% of cases showed extrapulmonary involvement. Tuberculosis at the surgical site is described in the medical literature with very few cases of cesarean section at the incision site. Nonhealing surgical site ulcers secondary to tuberculosis are not widely reported in the literature and treatment options to heal these lesions are not described. Surgical site infections resulting to a slow or nonhealing wound are commonly reported and usually depend on various factors. Patient factors include the patient’s immune status and comorbidities. Hospital management factors such as infection control policies in operation theatre, sterilization techniques for surgical instruments, and local wound care methods established and implemented by hospital staff. In this case report, a 34-year-old female with history of cesarean delivery 1 month back presented with nonhealing wound at the surgical site. We have done surgical repair with biopsy of wound margins. Wound discharge microscopy was negative for acid fast bacilli with few gram-positive cocci. Cartridge based nucleic acid amplification testes were positive for Mycobacterium tuberculosis genome. Histopathology shown tuberculous pathology and underlying chronic infectious process for nonhealing wound. We have offered antituberculosis treatment (ATT) as per protocol and observed healing of tuberculous ulcer after three months with reappearance of ulcer in fourth month of ATT. We have topically applied isoniazid and streptomycin over tuberculous ulcer along with systemic ATT. Tuberculous ulcer has responded and noted “cure” as completely healed surgical wound after 6 months of ATT with topical application of isoniazid and streptomycin.
format Article
id doaj-art-db9e7ea7581c4c9eb81f51b7596cd94b
institution Kabale University
issn 2949-785X
2949-7868
language English
publishDate 2024-09-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Annals of Medical Science and Research
spelling doaj-art-db9e7ea7581c4c9eb81f51b7596cd94b2025-08-20T03:59:36ZengWolters Kluwer Medknow PublicationsAnnals of Medical Science and Research2949-785X2949-78682024-09-013317517810.4103/amsr.amsr_38_23Local antituberculosis treatment in nonhealing chronic surgical site tuberculosis: A novel approach to cure nonhealing wound!Shital PatilDeepak PatilShubhangi KhuleGajanan GondhaliTuberculosis most commonly affects the lungs and less than 20% of cases showed extrapulmonary involvement. Tuberculosis at the surgical site is described in the medical literature with very few cases of cesarean section at the incision site. Nonhealing surgical site ulcers secondary to tuberculosis are not widely reported in the literature and treatment options to heal these lesions are not described. Surgical site infections resulting to a slow or nonhealing wound are commonly reported and usually depend on various factors. Patient factors include the patient’s immune status and comorbidities. Hospital management factors such as infection control policies in operation theatre, sterilization techniques for surgical instruments, and local wound care methods established and implemented by hospital staff. In this case report, a 34-year-old female with history of cesarean delivery 1 month back presented with nonhealing wound at the surgical site. We have done surgical repair with biopsy of wound margins. Wound discharge microscopy was negative for acid fast bacilli with few gram-positive cocci. Cartridge based nucleic acid amplification testes were positive for Mycobacterium tuberculosis genome. Histopathology shown tuberculous pathology and underlying chronic infectious process for nonhealing wound. We have offered antituberculosis treatment (ATT) as per protocol and observed healing of tuberculous ulcer after three months with reappearance of ulcer in fourth month of ATT. We have topically applied isoniazid and streptomycin over tuberculous ulcer along with systemic ATT. Tuberculous ulcer has responded and noted “cure” as completely healed surgical wound after 6 months of ATT with topical application of isoniazid and streptomycin.https://journals.lww.com/10.4103/amsr.amsr_38_23acid fast bacilliantituberculosis treatmenthistopathologysurgical woundtuberculosis
spellingShingle Shital Patil
Deepak Patil
Shubhangi Khule
Gajanan Gondhali
Local antituberculosis treatment in nonhealing chronic surgical site tuberculosis: A novel approach to cure nonhealing wound!
Annals of Medical Science and Research
acid fast bacilli
antituberculosis treatment
histopathology
surgical wound
tuberculosis
title Local antituberculosis treatment in nonhealing chronic surgical site tuberculosis: A novel approach to cure nonhealing wound!
title_full Local antituberculosis treatment in nonhealing chronic surgical site tuberculosis: A novel approach to cure nonhealing wound!
title_fullStr Local antituberculosis treatment in nonhealing chronic surgical site tuberculosis: A novel approach to cure nonhealing wound!
title_full_unstemmed Local antituberculosis treatment in nonhealing chronic surgical site tuberculosis: A novel approach to cure nonhealing wound!
title_short Local antituberculosis treatment in nonhealing chronic surgical site tuberculosis: A novel approach to cure nonhealing wound!
title_sort local antituberculosis treatment in nonhealing chronic surgical site tuberculosis a novel approach to cure nonhealing wound
topic acid fast bacilli
antituberculosis treatment
histopathology
surgical wound
tuberculosis
url https://journals.lww.com/10.4103/amsr.amsr_38_23
work_keys_str_mv AT shitalpatil localantituberculosistreatmentinnonhealingchronicsurgicalsitetuberculosisanovelapproachtocurenonhealingwound
AT deepakpatil localantituberculosistreatmentinnonhealingchronicsurgicalsitetuberculosisanovelapproachtocurenonhealingwound
AT shubhangikhule localantituberculosistreatmentinnonhealingchronicsurgicalsitetuberculosisanovelapproachtocurenonhealingwound
AT gajanangondhali localantituberculosistreatmentinnonhealingchronicsurgicalsitetuberculosisanovelapproachtocurenonhealingwound