Dale Adam P, Dedicoat Martin J, Saleem Tausif, Moran Ed
Department of Medical Microbiology, Basingstoke and North Hampshire Hospitals, Basingstoke, UK.
Department of Infectious Diseases and Tropical Medicine, Birmingham Heartlands Hospital, Heart of England NHS Hospital Trust, Birmingham, UK.
BMJ Case Rep. 2015 Jan 7;2015:bcr2014207546. doi: 10.1136/bcr-2014-207546.
We describe the case of a 46-year-old female patient treated for disseminated tuberculosis (TB) infection involving the lungs, urinary tract and skin. Following initiation of antituberculous therapy, the patient's right breast implant eroded through the overlying skin and was seen to be herniating through the resulting defect. The breast implant was removed under local anaesthetic and histological analysis of the resected tissue demonstrated granuloma formation consistent with periprosthetic TB. Wound healing following implant removal was poor and future breast augmentation surgery was only considered following completion of 12 months anti-TB treatment. This case constitutes the first report in the literature of percutaneous breast implant herniation resulting from periprosthetic infection with TB. A high index of suspicion is required to ensure early detection and timely management of TB and, in cases where periprosthetic pus aspirate is sterile, mycobacterial infection must be actively excluded.
我们描述了一例46岁女性患者的病例,该患者因肺部、泌尿道和皮肤播散性结核感染接受治疗。在开始抗结核治疗后,患者的右乳房植入物穿透覆盖的皮肤并从形成的缺损处突出。在局部麻醉下取出乳房植入物,对切除组织的组织学分析显示形成了与假体周围结核一致的肉芽肿。植入物取出后的伤口愈合不佳,仅在完成12个月的抗结核治疗后才考虑未来的隆胸手术。该病例是文献中首例因假体周围结核感染导致经皮乳房植入物突出的报告。需要高度怀疑以确保早期发现和及时处理结核病,并且在假体周围脓液抽吸无菌的情况下,必须积极排除分枝杆菌感染。