Mycobacterium abscessus Infection after Breast Lipotransfer: A Report of 2 Cases

Abstract

Mycobacterium abscessus is a rare, non-tuberculous, rapidly growing mycobacterium. Although it has been usually associated with chronic pulmonary infections in cystic fibrosis patients, the second most frequent infection sites are the skin and subcutaneous tissue. Most of the cutaneous infections described in the literature occur secondary to cosmetic invasive procedures, many of them in the context of medical tourism. Its atypical presentation and antibiotic-resistant nature make its diagnosis and therapeutics challenging. In this case report, we present 2 cases of M. abscessus infections secondary to breast lipotransfer reported in the same private center. Case 1 patient underwent surgery to treat scar contracture resulting from previous quadrantectomy. Case 2 patient underwent breast augmentation with lipotransfer. Both of them developed lesions in the breast and in the donor site (abdomen). The therapeutic regimen used was amikacin (1 g/24 h) + tigecycline (50 mg/12 h). In case 1, we performed a simple mastectomy, and in case 2, periodical ultrasound-guided drainages were performed as additional procedures. To our knowledge, these are the first 2 cases that describe an infection secondary to breast lipotransfer. The aim of our report was to illustrate the presentation, diagnosis, therapeutic management, and strategies available to prevent this complication.

Fig. 1.

Case 1: a 66-year-old woman with breast lesions during admission.

Fig. 2.

Case 1: breast lesions of the patient at 2 weeks before commencing treatment with amoxicillin/clavulanic was started.

Fig. 3.

Case 1: postoperative results of the patient. Simple mastectomy was performed, where the nipple–areola complex, skin, and gland were removed, and direct closure was done.

Fig. 4.

Case 2: a 29-year-old woman with breast and abdominal wall lesions during admission.