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[偶然分枝杆菌引起的迟发性持续性乳房植入物感染]

[DELAYED PERSISTENT BREAST IMPLANT INFECTION WITH MYCOBACTERIUM FORTUITUM].

作者信息

Dagan Jasmin, Reisfeld Sharon, Kwartin Samuel, Wolf Yoram

机构信息

Surgical Department, Hillel Yaffe Medical Center, Hadera.

Infectious Disease Unit, Hillel Yaffe Medical Center, Hadera.

出版信息

Harefuah. 2020 Aug;159(8):579-582.

Abstract

Non-Tuberculous Mycobacteria (NTM) are opportunistic environmental pathogens that can produce a wide range of diseases, including infection of the skin and soft tissues. Mycobacterium fortuitum is a predominant causative agent of postsurgical wound infection, especially in breast surgery. Peri-prosthetic infection due to Mycobacterium fortuitum are uncommon, but increasingly reported. This report summarizes the case of a young healthy female who underwent bilateral breast mastopexy with insertion of silicone implants. Shortly after the procedure she presented with clinical signs of wound infection that failed to heal completely in spite of repeated drainage and empiric antibiotic therapy. Additional microbiological investigation allowed for a diagnosis of Mycobacterium fortuitum. A prolonged course of anti-mycobacterial therapy, combined with removal of the implants initiated eradication of the infection and enabled re-implantation of the prosthesis. This case report underscores the importance of awareness to this type of pathogen especially in cases of exudative infection with sterile cultures. Timely identification can lead to prompt therapy of patients preventing further complications, costs and remaining aesthetic damage.

摘要

非结核分枝杆菌(NTM)是机会性环境病原体,可引发多种疾病,包括皮肤和软组织感染。偶然分枝杆菌是外科手术后伤口感染的主要病原体,尤其是在乳腺手术中。由偶然分枝杆菌引起的假体周围感染并不常见,但报告日益增多。本报告总结了一名年轻健康女性的病例,该女性接受了双侧乳房上提术并植入了硅胶假体。术后不久,她出现伤口感染的临床症状,尽管反复引流和经验性抗生素治疗,伤口仍未完全愈合。进一步的微生物学检查确诊为偶然分枝杆菌感染。延长抗分枝杆菌治疗疗程,并结合取出假体,最终根除了感染,并得以重新植入假体。本病例报告强调了认识此类病原体的重要性,尤其是在无菌培养的渗出性感染病例中。及时识别可促使患者得到及时治疗,预防进一步的并发症、费用以及残留的美学损害。

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