Infection of a venous port - beware of the Mycobacterium


  • Tseng Hui Heng Singapore General Hospital
  • Marcus Hin Yeung Loh Singapore General Hospital
  • Ying Ying Chua Singapore General Hospital
  • Bien Keem Tan Singapore General Hospital
  • Bien Soo Tan Singapore General Hospital



Venous port, port-a-cath, port pocket, subcutaneous, skin and soft tissue, Mycobacterium, non-tuberculous, abscessus, infection, resistance


An 84-year-old female with metastatic left breast cancer underwent a venous port insertion for chemotherapy. The port was inserted using standard techniques with image guidance under local anesthesia. She presented after 36 days with evidence of infection. A limited bedside ultrasound demonstrated free fluid surrounding the port. The port was subsequently removed the same day, at which time pus was expressed from the subcutaneous pocket. The culture from the pus grew Mycobacterium abscessus. She required removal of the port and wound debridement, wound dressings and a prolonged course of antibiotics. Mycobacterium abscessus is a group of rapidly growing, multidrug-resistant, non-tuberculous mycobacteria that are also relatively resistant to standard skin disinfectants. In recent years, this organism has been increasingly reported as the culprit in post-operative or post-procedural infections. Treatment is challenging due to multidrug resistance, and requires an extensive course of intravenous antimicrobial and macrolide-based combination therapy followed by oral antimicrobial therapy. Early treatment is essential as progression may result in disseminated infection. We discuss the peri-operative and post-operative care required in preventing and treating infection with this organism.

Author Biographies

Tseng Hui Heng, Singapore General Hospital

Senior Resident

Marcus Hin Yeung Loh, Singapore General Hospital


Ying Ying Chua, Singapore General Hospital

Senior Consultant

Bien Keem Tan, Singapore General Hospital

Head and senior consultant

Bien Soo Tan, Singapore General Hospital

Senior consultant





Interventional Radiology