Breast Infections With Atypical Mycobacteria Following Reduction Mammaplasty

Boettcher, Adam K.; Bengtson, Bradley P.; Farber, Scott T.; Ford, Ronald D.

doi:10.1177/1090820x10380543

Cited by 19 publications

(18 citation statements)

References 17 publications

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“…In a retrospective series, more than half of the skin infections after breast surgery were caused by Staphylococcus aureus, followed by Pseudomonas aeruginosa, Mixed flora, Coagulase-negative staphylococci, Enteric gram negative rods and Streptococus viridans group 14 . Apart from common skin pathogens, cases of nontuberculous mycobacterial infections (especially Mycobacterium fortuitum) complicating augmentation mammaplasty and breast reconstruction have been reported, but more recently M. fortuitum and Mycobacterium chelonae were also cultured from patients who underwent reduction mammaplasty 2,8,15 .…”

Section: Discussionmentioning

confidence: 99%

Rhodococcus equi infection after reduction mammaplasty in an immunocompetent patient

Sandkovsky

Sordillo

et al. 2011

Rev. Inst. Med. trop. S. Paulo

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SUMMARYThe majority of infections caused by R. equi occur in hosts with some degree of cell-mediated immunodeficiency. Immunocompetent individuals are infrequently affected and usually present with localized disease. Infections of the skin or related structures are uncommon and are usually related to environmental contamination. The microbiology laboratory plays a key role in the identification of the organism since it may be mistaken for common skin flora. We describe a 31 year-old woman without medical problems who presented nine weeks after breast reduction with right breast cellulitis and purulent drainage from the surgical wound. She underwent incision and drainage, and cultures of the wound yielded Rhodococcus equi. The patient completed six weeks of antimicrobial therapy with moxifloxacin and rifampin with complete resolution.

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Section: Discussionmentioning

confidence: 99%

Rhodococcus equi infection after reduction mammaplasty in an immunocompetent patient

Sandkovsky

Sordillo

et al. 2011

Rev. Inst. Med. trop. S. Paulo

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“…4 In the literature, only a few cases of M. fortuitum prosthetic infections have been reported. The outcome was poor with inevitable failure of reimplantation except in one case.…”

Section: Introductionmentioning

confidence: 98%

Treatment of Mycobacterium fortuitum Infection of Total Knee Arthroplasty: A Case Report

Yung¹,

Li²,

Lee³

et al. 2012

Journal of Orthopaedics, Trauma and Rehabilitation

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a b s t r a c tMycobacterium fortuitum is a rapidly growing bacterium that can cause infection at different sites in humans. Prosthetic infection caused by this bacterium has historically been a challenge, with reimplantation being unsuccessful in all but one case. M. fortuitum is resistant to almost all conventional antituberculous medications. There is no standardised treatment due to its rarity of occurrence. Here, we report a case of successful reimplantation with initial debridement surgery and 6 weeks of antibiotics. IntroductionMycobacterium fortuitum is a recognised cause of soft tissue infections at different sites in humans, for example, the cervical region, 1 abdominal wall, 2 skin 3 and breast. 4 In the literature, only a few cases of M. fortuitum prosthetic infections have been reported. The outcome was poor with inevitable failure of reimplantation except in one case. 5 There is no consensus of treatment. Case reportA 64-year-old woman had osteoarthritis of both knees. Preoperative X-rays of her left knee (Figure 1) showed no obvious sign of infection. There had been a history of intra-articular injection of unknown drugs of both knees before left total knee arthroplasty ( Figure 2) (Legacy posterior stabilized knee, Warsaw, Zimmer) was performed in 2003. Preoperative and intraoperative assessments showed no signs of infection. At 10 weeks after the operation, the patient complained of increased pain in her left knee. Physical examination showed increased temperature in the left knee with effusion. The blood test showed an elevated C-reactive protein level of 48.9 mg/L. Left knee aspiration was done and joint fluid was sent for investigation. Joint fluid culture was negative but microscopy found an increased number of neutrophils. Acid-fast bacillus smear was negative. Acid-fast bacillus culture yielded M. fortuitum, which was sensitive to amikacin, ciprofloxacin and imipenem but resistant to rifampicin, tetracycline and clarithromycin.Exploration was done 12 weeks after the first operation. Intraoperatively, pus was found inside the joint. Removal of the implant and insertion of a hand-moulded articulating cement spacer made from one pack of antibiotic-loaded cement (500 mg tobramycin in 40 g Simplex cement) were performed (Figure 3). Intraoperative frozen section showed >20 neutrophils per high-power field (40Â). Intraoperative fluid culture showed mycobacterial species. After the operation, the patient was placed on intravenous amikacin (500 mg/day) for 6 weeks and oral ciprofloxacin (500 mg twice daily orally) for 6 weeks in total, as suggested by the microbiologist. Two months after insertion of the cement spacer, the pain improved and signs of inflammation subsided. The extension to flexion range of her left knee was 10e80 . The C-reactive protein level went down from 48.9 mg/L to 5.0 mg/L. One month later, revision total knee replacement (Figure 4) was done. Intraoperative frozen section confirmed that the neutrophils count was <5 per

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“…Although NTM-infections more commonly occur in immunodeficient patients (e.g. HIV-positive, under chemotherapy or corticosteroid treatment), several plastic surgeons have reported cases of SSI with RGM after cosmetic operations, such as abdominoplasty, liposuction, breast augmentation, breast reduction, buttock lift, and facelift [12][13][14][15][16][17]. Of all the RGM's, Mycobacterium Fortuitum (MF) is the one that is most frequently associated with aesthetic surgery infections [6,7,16,18].…”

Section: Introductionmentioning

confidence: 99%

Mycobacterium Fortuitum infection after abdominoplasty and breast reduction: case report, diagnostic tips and tricks, and overview of the current therapeutic consensus

Randy¹,

Assaf²,

Moustapha³

et al. 2019

Hyoid Bone Osteosarcoma: Report of a Case and Review of the Literature

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Background: Surgical site infections caused by non-tuberculous mycobacteria (NTM) are increasingly reported in the literature. Mycobacterium Fortuitum is the one that is most frequently associated with surgical site infections. Case Presentation: We present our first case of Mycobacterium Fortuitum infection after combined abdominoplasty and bilateral breast reduction. Discussion and Conclusions: Diagnosis of NTM-infections remains difficult. Typical symptoms are minor wound dehiscences with the evacuation of clear, odorless fluid collections. The onset can vary between one week to two years postoperatively. A wound dehiscence of a previously closed wound or slow healing of a wound must encourage a prompt diagnosis. A proper amount of fluid collection and/or tissue biopsy are necessary for an accurate diagnosis. Acid-fast or fluorochrome staining are also preferred over classic Gram staining. Treatment consists of proper surgical debridement and long-term, targeted, antibiotic combination therapy. Surgical debridement involves surgical drainage and removal of any infected foreign material. With regards to the antibiotic treatment, a dual antibiotic therapy, consisting of an oral Macrolide with initial parental therapy of Amikacin, is recommended. However, other combinations have been reported and also seem efficacious. An antibiotic treatment of four to six months is advised. The prognosis is usually favorable, although complete healing can sometimes be annoyingly long.

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Breast Infections With Atypical Mycobacteria Following Reduction Mammaplasty

Cited by 19 publications

References 17 publications

Rhodococcus equi infection after reduction mammaplasty in an immunocompetent patient

Rhodococcus equi infection after reduction mammaplasty in an immunocompetent patient

Treatment of Mycobacterium fortuitum Infection of Total Knee Arthroplasty: A Case Report

Mycobacterium Fortuitum infection after abdominoplasty and breast reduction: case report, diagnostic tips and tricks, and overview of the current therapeutic consensus

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