Bies Jared J, Allen Jesse C, Barsi Zahra E, Hassan Mariam, Prakash Swathi, Aguilar Mateo-Porres, Meza Armando, Peralta Diego P
Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA.
Infectious Diseases, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA.
Cureus. 2023 Dec 3;15(12):e49881. doi: 10.7759/cureus.49881. eCollection 2023 Dec.
Cosmetic surgeries are very popular and glamorized by the mainstream media and celebrities. Many individuals perceive certain bodily features as appealing for physical attraction and will attempt to obtain these features by surgery. However, these surgeries are not without risk, and significant consequences can occur if not performed by qualified medical professionals under sterile procedures. The authors present novel cases of two healthy young female patients who underwent a Brazilian butt lift (BBL) procedure a week apart by the same plastic surgeon in Mexico and developed dark painful lesions secondary to (), a multidrug-resistant non-tuberculous mycobacterium (NTM). The literature review shows a paucity of data concerning NTM infections via surgical procedures of this type. The first case was of a 31-year-old woman who underwent a BBL and presented with bilateral dark painful buttock lesions weeks later. The patient returned to the plastic surgeon, who drained some lesions and prescribed oral antibiotics. The patient's clinical status continued to deteriorate and presented to the hospital for further assessment. The patient was initially started on broad-spectrum antibiotic therapy. The patient was found to have an HIV infection with a relatively preserved CD4 lymphocyte count and was started on antiretroviral therapy (ART). Intraoperative excisional tissue sample cultures grew . The patient was started on empiric tigecycline, cefoxitin, and linezolid. Preliminary culture susceptibilities showed resistance to linezolid. Linezolid was discontinued, amikacin was started, and cefoxitin and tigecycline were continued. Tigecycline, cefoxitin, and amikacin were continued and final susceptibilities showed sensitivity to the current treatment. The patient received a total of four months of treatment with tigecycline, cefoxitin, and amikacin. The second case was of a 28-year-old woman who underwent a BBL a week after the first patient by the same surgeon and developed multiple gluteal and body abscesses. The patient underwent bilateral thigh and gluteal, right chest wall, and breast surgical debridements with intraoperative cultures at a different hospital facility, which grew . Susceptibilities were not performed there. The patient was transferred to our facility for further care. Intraoperative cultures remained negative, and the patient was treated with a six-month course of tigecycline, cefoxitin, and amikacin.
整容手术非常受欢迎，并且受到主流媒体和名人的追捧。许多人认为某些身体特征具有吸引力，会试图通过手术来获得这些特征。然而，这些手术并非没有风险，如果不是由合格的医学专业人员在无菌程序下进行，可能会产生严重后果。作者介绍了两例健康年轻女性患者的新病例，她们在墨西哥由同一位整形外科医生相隔一周进行了巴西臀部提升术（BBL），术后继发于一种耐多药非结核分枝杆菌（NTM），出现了深色疼痛性病变。文献综述显示，关于此类手术导致NTM感染的数据很少。第一例患者是一名31岁女性，接受了BBL手术，几周后双侧臀部出现深色疼痛性病变。患者返回整形外科医生处，医生排出了一些病变并开了口服抗生素。患者的临床状况持续恶化，前往医院进行进一步评估。患者最初开始接受广谱抗生素治疗。发现患者感染了HIV，CD4淋巴细胞计数相对保留，并开始接受抗逆转录病毒治疗（ART）。术中切除组织样本培养物培养出……。患者开始经验性使用替加环素、头孢西丁和利奈唑胺治疗。初步培养药敏结果显示对利奈唑胺耐药。停用利奈唑胺，开始使用阿米卡星，并继续使用头孢西丁和替加环素。继续使用替加环素、头孢西丁和阿米卡星，最终药敏结果显示对当前治疗敏感。该患者总共接受了四个月的替加环素、头孢西丁和阿米卡星治疗。第二例患者是一名28岁女性，在第一例患者术后一周由同一位外科医生进行了BBL手术，出现了多处臀部和身体脓肿。患者在另一家医院接受了双侧大腿和臀部、右胸壁和乳房的手术清创，并进行了术中培养，培养出……。那里未进行药敏试验。患者被转到我们的机构接受进一步治疗。术中培养结果仍为阴性，患者接受了为期六个月的替加环素、头孢西丁和阿米卡星治疗。
