Management of
Mycobacterium abscessus infection involves prolonged multidrug
antibiotic therapy with surgical resection indicated in extensive disease and
abscesses. We report a case of post-surgical intra-abdominal M. abscessus
infection with prolonged survival and radiographic resolution without intervention. A 51-year-old female who had a prolonged
hospital stay with multiple surgeries following a complicated laparoscopic sleeve
gastrectomy developed multiple M. abscessus intra-abdominal and abdominal wall
abscesses with cutaneous fistulae. She was started on a multidrug
antibiotic regimen. However, the patient terminated the regimen after 4 weeks due to intolerable side effects and was transitioned to
hospice care. She showed steady clinical improvement with radiographic resolution of the
abscesses over the next year. In the context of the limited understanding of these
infections, our finding is notable, given that in this period, she avoided potential hospitalizations, life altering side effects of prolonged antimicrobial
therapy, and complications from more surgeries.