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April 1977

Tuberculous Infection in a Vascular Prosthesis

Arch Surg. 1977;112(4):539. doi:10.1001/archsurg.1977.01370040191035

To the Editor.—I have read with interest the article entitled "Tuberculous Infection in a Vascular Prosthesis" in the January 1977 issue of the Archives (112:79, 1977) by Wright and co-workers. Five years ago, we treated a patient who had developed infection in the prosthetic segment of a femoroposterior tibial composite Dacron vein bypass graft, secondary to Mycobacterium tuberculosis. We failed to report this case because we did not appreciate its full significance.

The patient in question hemorrhaged from the Dacron segment six weeks postoperatively. On reexploration, the usual signs of sepsis were not evident. The usual aerobic and anaerobic smears and cultures were performed, but were not revealing. The first time, surgical management was carried out as if sepsis was not present, but hemorrhage recurred. Revision of the reconstruction was then performed using extra-anatomic principles to avoid infected tissue via the obturator bypass technique.1 Four weeks later, hemorrhage occurred

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