Rhie Jong Won, Jeong Yeon Jin, Kim Sang Wha
Department of Plastic and Reconstructive Surgery, The Catholic University of Korea, Seoul, South Korea.
J Craniofac Surg. 2013 Jul;24(4):1257-9. doi: 10.1097/SCS.0b013e3182902e02.
Nontuberculous mycobacteria (NTM) are important pathogens for cutaneous infections related to contaminated environments and invasive procedures.A 43-year-old woman presented with swelling of the forehead. Ten years ago, she underwent augmentation rhinoplasty using silicone implant. In response to the swelling, an incision was made, pus-like discharge was drained, and the nasal silicone implant was removed. Although routine culture and NTM culture showed negative results, NTM polymerase chain reaction detected NTM infection. After continued clarithromycin medication for 3 months, the patient recovered without recurrence of infection.Mycobacteria are rarely detected with routine bacterial culture and are often resistant to empiric antibacterial agents. Therefore, the possibility of NTM infection should always be included in differential diagnosis, when evaluating skin lesions, regardless of the immune status of the patient.
非结核分枝杆菌(NTM)是与受污染环境及侵入性操作相关的皮肤感染的重要病原体。一名43岁女性出现前额肿胀。十年前,她接受了硅胶植入隆鼻手术。针对肿胀情况,进行了切开引流,排出脓性分泌物,并取出了鼻硅胶植入物。尽管常规培养和NTM培养结果均为阴性,但NTM聚合酶链反应检测到NTM感染。在持续使用克拉霉素治疗3个月后,患者康复且感染未复发。常规细菌培养很少能检测到分枝杆菌,且其通常对经验性抗菌药物耐药。因此,在评估皮肤病变时,无论患者免疫状态如何,鉴别诊断中都应始终考虑NTM感染的可能性。