Atypical Mycobacterial Infection after Abdominoplasty Overseas: A Case Report and Literature Review

Abstract

Increasing number of medical tourists travel internationally for cosmetic procedures. Lipotourism is a form of medical tourism becoming popular among patients of developed countries due to the cost efficiency of cosmetic procedures when performed in developing nations. There is a paucity of data on quality, safety, and risks involved with these surgeries. Many cases of infections have been documented in patients following cosmetic surgeries in developing countries. We present a case of a 34-year-old female who underwent abdominoplasty in Dominican Republic that was complicated with development of multiple abdominal wall abscesses due to infection from rapidly growing mycobacteria (RGM). In the absence of clear treatment guidelines, she was treated with a combination of intermittent surgical drainage and prolonged antibiotic course. This case is of interest as more than one species of RGM was isolated from the same patient. Our case highlights the fact that identification of these organisms can be difficult requiring referral of samples to specialized laboratories and treatment duration can last several months, which is determined by clinical and microbiological response.

Figure 1

CT abdomen and pelvis with intravenous contrast showing large subcutaneous collection in the anterior abdominal wall (blue arrow) suggestive of abscess.

Figure 2

Soft, fluctuant, erythematous, and tender swelling in the lateral aspect of left hip.

Figure 3

Soft, fluctuant, erythematous, and tender swelling in the lower central back (upper border of the tattoo).

Figure 4

CT abdomen and pelvis with intravenous contrast showing subcutaneous rim-enhancing lesion in the left flank (blue arrow) suggestive of an abscess.