Cárdenas-Camarena Lázaro, Cárdenas-Cruz Cristopher, Godínez Iván González
From the Department of Plastic Surgery, Innovare Hospital, Zapopan, Jalisco, Mexico.
Surgery Department, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr Bernardo Sepúlveda," Mexico City, Mexico.
Plast Reconstr Surg Glob Open. 2025 Apr 17;13(4):e6715. doi: 10.1097/GOX.0000000000006715. eCollection 2025 Apr.
The rise in aesthetic surgery in recent years has led to an increased incidence of complications associated with these procedures. Liposuction and autologous fat transfer have become some of the most common cosmetic interventions worldwide, also raising the risk of developing postoperative infections, including those caused by multidrug-resistant Gram-negative bacilli, which can be life-threatening. We present the case of a 40-year-old woman who developed septic shock secondary to deep necrotizing fasciitis in the right thigh following liposuction and autologous fat transfer to the buttocks. During the postoperative period, she developed a necrotizing soft tissue infection affecting the right thigh and buttock, which progressed to necrotizing fasciitis. The patient required surgical debridement, fasciotomy, and combined antibiotic therapy. Tissue cultures revealed multidrug-resistant complex haemolyticus, sensitive to carbapenems. The patient had surgical debridement and a 14-day course of antibiotics, resulting in clinical recovery. is a significant cause of nosocomial infections worldwide, and its persistence on inanimate surfaces may be underestimated. Complications such as necrotizing soft tissue infections are typically caused by Gram-positive microorganisms such as methicillin-resistant and Gram-negative fermenting enterobacteria. The isolation of in soft tissue cultures is unusual, making this case notable, as necrotizing soft tissue infections caused by this nonfermenting Gram-negative bacillus have not been previously reported following aesthetic body contouring surgery.
近年来，美容手术的增加导致了与这些手术相关的并发症发生率上升。吸脂术和自体脂肪移植已成为全球最常见的美容干预手段之一，同时也增加了术后感染的风险，包括由多重耐药革兰氏阴性杆菌引起的感染，这些感染可能危及生命。我们报告了一例40岁女性的病例，该患者在进行吸脂术并将自体脂肪移植到臀部后，右大腿发生了继发于深部坏死性筋膜炎的感染性休克。术后期间，她出现了累及右大腿和臀部的坏死性软组织感染，并进展为坏死性筋膜炎。患者需要进行手术清创、筋膜切开术和联合抗生素治疗。组织培养显示为多重耐药溶血不动杆菌，对碳青霉烯类敏感。患者接受了手术清创和为期14天的抗生素治疗，最终临床康复。溶血不动杆菌是全球医院感染的一个重要原因，其在无生命表面的持续存在可能被低估。坏死性软组织感染等并发症通常由革兰氏阳性微生物如耐甲氧西林金黄色葡萄球菌和革兰氏阴性发酵肠杆菌引起。在软组织培养中分离出溶血不动杆菌并不常见，这使得该病例值得关注，因为此前尚未有报道称在美容身体塑形手术后会出现由这种非发酵革兰氏阴性杆菌引起的坏死性软组织感染。
