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美容手术后迅速生长的分枝杆菌感染:Bronx 的经验和文献复习。

Rapidly growing Mycobacterium infections after cosmetic surgery in medical tourists: the Bronx experience and a review of the literature.

机构信息

Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA.

Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA.

出版信息

Int J Infect Dis. 2017 Oct;63:1-6. doi: 10.1016/j.ijid.2017.07.022. Epub 2017 Aug 2.

Abstract

BACKGROUND

Medical tourism is increasingly popular for elective cosmetic surgical procedures. However, medical tourism has been accompanied by reports of post-surgical infections due to rapidly growing mycobacteria (RGM). The authors' experience working with patients with RGM infections who have returned to the USA after traveling abroad for cosmetic surgical procedures is described here.

METHODS

Patients who developed RGM infections after undergoing cosmetic surgeries abroad and who presented at the Montefiore Medical Center (Bronx, New York, USA) between August 2015 and June 2016 were identified. A review of patient medical records was performed.

RESULTS

Four patients who presented with culture-proven RGM infections at the sites of recent cosmetic procedures were identified. All patients were treated with a combination of antibiotics and aggressive surgical treatment.

CONCLUSIONS

This case series of RGM infections following recent cosmetic surgeries abroad highlights the risks of medical tourism. Close monitoring of affected patients by surgical and infectious disease specialties is necessary, as aggressive surgical debridement combined with appropriate antibiotic regimens is needed to achieve cure. Given the increasing reports of post-surgical RGM infections, consultants should have a low threshold for suspecting RGM, as rapid diagnosis may accelerate the initiation of targeted treatment and minimize morbidity.

摘要

背景

出于美容整形的目的,越来越多的人选择出国进行医疗旅游。然而,医疗旅游也伴随着术后感染快速生长分枝杆菌(RGM)的报道。本文描述了作者在国外进行美容手术后返回美国的 RGM 感染患者的治疗经验。

方法

2015 年 8 月至 2016 年 6 月,作者在位于美国纽约布朗克斯的蒙蒂菲奥里医疗中心(Montefiore Medical Center),对患有 RGM 感染的出国美容手术患者进行了识别。对患者的病历进行了回顾。

结果

共确定了 4 名在最近的美容手术后出现 RGM 感染的患者。所有患者均接受抗生素联合积极手术治疗。

结论

本国外美容手术后 RGM 感染的病例系列强调了医疗旅游的风险。需要外科和传染病专科对受影响的患者进行密切监测,因为需要积极的手术清创术联合适当的抗生素方案来实现治愈。鉴于术后 RGM 感染的报道越来越多,顾问应该对 RGM 保持低阈值,因为快速诊断可能会加速针对性治疗的启动,并最大程度地减少发病率。

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