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Case Report
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| A case of an Ureaplasma infection causing significant soft tissue destruction to the vagina, perineum and abdominal wall in a patient with hypogammaglobulinemia | ||||||
| Debbie Hunt1, Shomari Dotun Lee Zack-Williams1, Janet Purcell1, John Cheesbrough2, Jeyramam Srinivasan3 | ||||||
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1MBCHB, Royal Preston Hospital, Preston, Lancashire, United Kingdom.
2MBBS, BSc, MRCP, FRCPath2, Royal Preston Hospital, Preston, Lancashire, United Kingdom. 3MBBS, FRCSEd, FRCSEd (PLAST), Royal Preston Hospital, Preston, Lancashire, United Kingdom. | ||||||
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| Hunt D, Zack-Williams SDL, Purcell J, Cheesbrough J, Srinivasan J. A case of an Ureaplasma infection causing significant soft tissue destruction to the vagina, perineum and abdominal wall in a patient with hypogammaglobulinemia. Int J Case Rep Imag 2016;7(4):267–271. |
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Abstract
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Introduction:
Ureaplasma species make up part of the normal genital flora and rarely penetrate the submucosa, except in the case of immunosuppression/instrumentation. However, so far in literature, there is no cases of Ureaplasma causing significant tissue loss. We present a case of significant tissue destruction of the abdominal wall and perineum caused by Ureaplasma.
Case Report: A 23-year-old female with B lymphocyte deficiency presented with a urinary tract infection (UTI) which quickly progressed into recurrent abscesses and then widespread infection of the pubic region and genitalia, requiring multiple surgical debridement. This leads to a significant soft tissue defect producing complex reconstructive challenges. A distally based rectus abdominis turn down flap and skin graft was used to reconstruct the pubic defect. However, despite the flap being viable and no outward evidence of infection, the healthy tissue did not heal. In addition, the surgical wound used to raise the flap broke down and the anterior rectus sheath disintegrated. Despite multiple wound swabs and cultures the cause could not be isolated. Numerous broad spectrum antibiotics were trialed, yet the wound persisted for over a year, with recurrent admissions and operations. Finally, specific viral transport medium and PCR identified Ureaplasma and after starting doxycycline, the patient drastically improved within weeks. Conclusion: It is important to suspect mycoplasma when the clinical picture indicates infection, but the infectious agent cannot be isolated on standard culturing methods. Involving support from microbiologists early would be helpful in such cases. | |
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Keywords:
Abdominal wall, Destruction to the vagina, Hypogammaglobulinemia, Perineum
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Author Contributions
Debbie Hunt – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Shomari Dotun Lee Zack-Williams – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Janet Purcell – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published John Cheesbrough – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Jeyramam Srinivasan – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Debbie Hunt et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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