Deng Lin, Luo Ying-Zhi, Liu Fang, Yu Xiao-Hong
Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China.
Department of Dermatology, Jinling Hospital, Nanjing 210002, Jiangsu Province, China.
World J Clin Cases. 2022 Jun 26;10(18):6141-6147. doi: 10.12998/wjcc.v10.i18.6141.
In recent years, the cosmetic intervention related infections caused by nontuberculous mycobacteria (NTM) are increasing as the informal cosmetic treatments are performed. However, many dermatologists are inexperienced in the diagnosis and management of similar cases. Here we report a case of subcutaneous infection caused by () following cosmetic injections of botulinum toxin.
A 53-year-old woman presented with multiple abscesses and nodules on her forehead and both temporal sites for half a month after cosmetic injections of botulinum toxin. Her lesions did not show any alleviation after 2-wk prescription of antibiotics. Laboratory examinations indicated that she had no sign of immunodeficiency and the whole body of computed tomography did not find any systemic infection or diseases. The pathology of skin tissue showed inflammatory cell infiltration with the negative results of Periodic acid Schiff (PAS) and Acid-fast staining and the culture yielded no microbiome. Afterwards, the puncture on abscess was performed and was successfully isolated. The pathogen was identified by acid-fast staining and DNA sequencing. The patient was treated with the strategy of clarithromycin, ofloxacin, and amikacin according to the result of drug sensitivity test and got complete remission of the lesions.
The case presents the whole process of diagnosis and management of NTM infection after cosmetic intervention and highlights the diagnostic thoughts. In a word, the mycobacterium infection should be aware in patients after cosmetic performance.
近年来,随着非正规美容治疗的开展,非结核分枝杆菌(NTM)引起的美容干预相关感染不断增加。然而,许多皮肤科医生对类似病例的诊断和管理经验不足。在此,我们报告1例肉毒毒素美容注射后由()引起的皮下感染病例。
1例53岁女性在肉毒毒素美容注射后半个月,前额及双侧颞部出现多发脓肿和结节。给予抗生素治疗2周后,其皮损无任何缓解。实验室检查表明她没有免疫缺陷迹象,全身计算机断层扫描未发现任何全身感染或疾病。皮肤组织病理学显示有炎性细胞浸润,高碘酸希夫(PAS)染色和抗酸染色结果均为阴性,培养未发现微生物群。之后,对脓肿进行穿刺,成功分离出()。通过抗酸染色和DNA测序鉴定病原体。根据药敏试验结果,患者采用克拉霉素、氧氟沙星和阿米卡星治疗,皮损完全缓解。
本病例展示了美容干预后NTM感染的诊断和管理全过程,并突出了诊断思路。总之,美容操作后的患者应警惕分枝杆菌感染。