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Case Reports
. 2020 Oct 25:22:e00992.
doi: 10.1016/j.idcr.2020.e00992. eCollection 2020.

Mycobacterium abscessus subspecies abscessus infection associated with cosmetic surgical procedures: Cases series

C Moreno-Izquierdo  1   2   3 , J Zurita  2   4 , F I Contreras-Yametti  1 , M A Jara-Palacios  1
Affiliations
Case Reports

Mycobacterium abscessus subspecies abscessus infection associated with cosmetic surgical procedures: Cases series

C Moreno-Izquierdo et al. IDCases. .

Abstract

Background: Mycobacterium abscessus is one of the most pathogenic and drug-resistant opportunistic microorganisms among the nontuberculous mycobacteria (NTM) involved in skin and soft tissue infections (SSTI) associated with cosmetic surgical procedures. However, NTM infection is often wrongly diagnosed initially causing prolonged suffering. Here is described the author's experience working with patients who developed M. abscessus SSTI after cosmetic procedures.

Methods: Patients who developed NTM infection after undergoing cosmetic procedures, and who presented at the Hospital Metropolitano and Hospital Vozandes (Quito, Ecuador) between 2013-2016. A review of patient medical records was performed.

Results: Five patients with culture proven M. abscessus subspecies abscessus SSTI after cosmetic surgeries were identified. All patients were treated with aggressive surgical debridement and antibiotics.

Conclusions: A rapidly spreading wound infection presenting two or more weeks after a cosmetic procedure that fails to respond to standard antimicrobial therapy should raise suspicion for NTM infection. Samples for acid-fast bacilli smear, cultures, and PCR from infected tissue should be taken. Surgical drainage and debridement are recommended along with a long course of antibiotics. In the absence of clinical trials, a combination of amikacin, imipenem, and clarithromycin may be an adequate initial treatment for M. abscessus subspecies abscessus SSTI in immunocompetent patients.

Keywords: Clarithromycin; Cosmetic surgery; Mycobacterium abscessus; Nontuberculous mycobacteria; Surgical infection.

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Conflict of interest statement

The authors report no declarations of interest.

Figures

Fig. 1
Fig. 1
Different manifestations in skin and soft tissues caused by M. abscessus after cosmetic surgery. M. abcessus infection usually follows penetrating trauma in immunocompetent individuals. Initial presentation includes the formation of a tender, fluctuating subcutaneous abscess at the site of inoculation (G). Other presentations include ulcerations, sinus drainage, or nodules (A, C, D). Abscesses that drain large amounts of pus (B) or chronic ulcers (F). The primary lesion is often followed by a sporotrichoid aspect of ascending lymphadenitis.
See this image and copyright information in PMC

References

    1. Sander M.A., Isaac-Renton J.L., Tyrrell G.J. Cutaneous nontuberculous mycobacterial infections in Alberta, Canada: an epidemiologic study and review. J Cutan Med Surg. 2018;22(5):479–483. - PubMed
    1. Griffith D.E., Aksamit T., Brown-Elliott B.A., Catanzaro A., Daley C., Gordin F. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175(4):367–416. - PubMed
    1. Le Dantec C., Duguet J.P., Montiel A., Dumoutier N., Dubrou S., Vincent V. Occurrence of mycobacteria in water treatment lines and in water distribution systems. Appl Environ Microbiol. 2002;68(11):5318–5325. - PMC - PubMed
    1. Van Ingen J., Blaak H., De Beer J., De Roda Husman A.M., Van Soolingen D. Rapidly growing nontuberculous mycobacteria cultured from home tap and shower water. Appl Environ Microbiol. 2010;76(17):6017–6019. - PMC - PubMed
    1. Falkinham J.O., III Surrounded by mycobacteria: nontuberculous mycobacteria in the human environment. J Appl Microbiol. 2009;107(2):356–367. doi: 10.1111/j.1365-2672.2009.04161.x. [Internet]. Available from: - DOI - PubMed

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