Newman Martin I, Camberos Alfonso E, Ascherman Jeffrey
Department of Plastic and Reconstructive Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
Ann Plast Surg. 2005 Jul;55(1):107-10; discussion 110. doi: 10.1097/01.sap.0000168030.87804.93.
We recently encountered 5 patients with Mycobacterium abscessus infection following cosmetic procedures performed at a surgicenter located off the United States coastline which, by report, actively recruits domestic patients. Additional patients with similar clinical histories and presentation have been identified at other practices along the Eastern seaboard as well. A recent Centers for Disease Control and Prevention investigation has confirmed a common link. All procedures were performed in Santo Domingo, Dominican Republic, between 2003 and 2004. More than half were performed at the same facility. We report herein a series of patients presenting with M. abscessus infections who underwent cosmetic surgery offshore. The goal of this manuscript is to heighten awareness among physicians who may encounter such patients in their practices. The indolent clinical presentation, laboratory studies utilizing acid-fast stains and cultures, and treatment including surgical debridement and pharmacologic regimens in the ultimate diagnosis and therapy for M. abscessus infections are discussed.
我们最近遇到了5例脓肿分枝杆菌感染患者,他们在美国海岸线外的一家外科中心接受了美容手术后感染。据报道,该中心积极招揽国内患者。在东海岸的其他医疗机构也发现了具有类似临床病史和表现的患者。美国疾病控制与预防中心最近的一项调查证实了一个共同的关联。所有手术均于2003年至2004年在多米尼加共和国的圣多明各进行。超过一半的手术是在同一机构进行的。我们在此报告一系列在海外接受美容手术并出现脓肿分枝杆菌感染的患者。本文的目的是提高在临床工作中可能遇到此类患者的医生的认识。文中讨论了脓肿分枝杆菌感染在最终诊断和治疗中的惰性临床表现、利用抗酸染色和培养的实验室检查,以及包括手术清创和药物治疗方案在内的治疗方法。