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面部进行冷冻保存脂肪移植后出现非典型分枝杆菌和曲霉菌混合感染。

Mixed infection of an atypical Mycobacterium and Aspergillus following a cryopreserved fat graft to a face.

作者信息

Kim Seong Kee, Kim Han Joon, Hwang Kun

机构信息

Fom the *Department of Plastic Surgery, Inha University School of Medicine, Incheon; †Dr Kim's Aesthetic Surgical Plastic Clinic, Seoul; and ‡Center for Advanced Medical Education by the BK21 Project, Inha University School of Medicine, Incheon, Korea.

出版信息

J Craniofac Surg. 2013 Sep;24(5):1676-8. doi: 10.1097/SCS.0b013e31828f27ee.

Abstract

We report a chronic infection of a patient who received a cryopreserved fat graft on her face. A 22-year-old female patient presented with multiple abscesses of her face. Four months previously, she received a second fat graft with the fat harvested at a previous surgery which was cryopreserved for 2 months. On examination, she had tender erythematous nodules on both cheeks. A computed tomography of her neck showed multiple peripheral enhancing nodular lesions. In an open pus fungus culture, Aspergillus fumigatus growth was observed. On the Mycobacterium Other Than Tuberculosis identification PCR, Mycobacterium fortuitum was found. She was treated with levofloxacin, clarithromycin, and minocycline for 11 months, and finally the symptoms subsided. To avoid infection after the fat graft, cryopreserved fat should not be used as a possible grafting material. In cases of persistent infection, or in cases of waxes and gains after drainage of pus and short-term antibiotics therapy, atypical Mycobacterium or Aspergillus should be suspected and a PCR for them should be carried out.

摘要

我们报告了一名接受面部冷冻保存脂肪移植的患者发生慢性感染的病例。一名22岁女性患者面部出现多处脓肿。四个月前,她接受了第二次脂肪移植,所用脂肪是在之前一次手术中采集并冷冻保存了2个月的。检查时,她双颊有触痛的红斑结节。其颈部计算机断层扫描显示多个周边强化的结节性病变。在开放性脓液真菌培养中,观察到烟曲霉生长。在非结核分枝杆菌鉴定聚合酶链反应(PCR)中,发现了偶然分枝杆菌。她接受左氧氟沙星、克拉霉素和米诺环素治疗11个月,最终症状消退。为避免脂肪移植后感染,不应将冷冻保存的脂肪用作可能的移植材料。在持续感染的情况下,或在脓液引流和短期抗生素治疗后病情反复的情况下,应怀疑非典型分枝杆菌或曲霉感染,并对其进行PCR检测。

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