VCOM Research Day Program Book 2023

Medical Student Research Case Reports

23 Consideration of Pre- and Post-Operative Infection Risks in Management of Bladder Exstrophy: A Case Report

Tashi Bharathan; Dr. Zairha Gonzalez Snider, MD Corresponding author: tbharathan@vt.vcom.edu

Edward Via College of Osteopathic Medicine-Virginia Campus New River Valley Pediatrics, Radford, Virginia

Bladder exstrophy is a rare congenital anomaly. The estimated prevalence in the United States is approximately 3.3 per 100,000 live births. It is characterized by abnormalities involving the urinary, genital, and musculoskeletal systems in which the bladder remains patent through a lower abdominal defect with wide pubic separation. Due to the anatomical anomalies that lead to stasis, obstruction, and urinary reflux along with the impaired skin barrier, patients are at an increased risk for bacterial and fungal infections. The literature identifies infection as a major complication of post-surgical repair; however, there are relatively few reports on

preoperative infection risks. We present a case of a 3-month-old infant, who underwent preoperative evaluation for complete primary repair of bladder exstrophy and concurrent pelvic external fixation. During the assessment, an erythematous papular rash was noted in the distribution of the diaper. Due to the increased risk for wound infections in patients who have an underlying infection at the time of surgery, the patient was not cleared for surgery and was subsequently started on broad-spectrum antibiotics and antifungal medication. Surgery is the mainstay of treatment for bladder exstrophy; therefore, a thorough understanding of both pre- and post-infection

risks is imperative for minimizing postoperative morbidity, long-term management, and prevention of antimicrobial resistance. All patients/participants in this study provided informed consent prior to preparing this case report.

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