Case ReportBreast implant infection with Mycobacterium fortuitum group: Report of case and review
Introduction
Breast implant-related infections, albeit uncommon, are typically caused by bacterial skin flora, specifically Staphylococcus aureus and coagulase-negative staphylococci, introduced at the time of surgery.1, 2 Infections caused by mycobacteria, however, are uncommon, but are being increasingly reported.2, 3, 4, 5, 6 Of breast implant infections caused by such pathogens, the non-pigmented, rapidly growing members of the Mycobacterium fortuitum complex are the most frequently reported.2, 6, 7, 8, 9 We report a case of a female who underwent augmentation mammoplasty and presented approx. 1 month later with clinical evidence of an infected breast prosthesis. The complexities established in the diagnosis and need for a thorough and accurate microbiologic evaluation are summarized in the case report and discussion that ensue.
Section snippets
Case report
A 27-year-old healthy female underwent bilateral augmentation mammoplasty for hypomastia and ptosis. The 480 cm3 smooth implants were filled to a capacity of 510 cm3 and placed subglandularly, using inframammary incisions. At the time of surgery, each pocket was irrigated with copious amounts of a mixture of bacitracin in saline. One month after the procedure, the patient developed sudden onset of pain and swelling of the right breast with an associated sensation of fever, which resolved within 1
Discussion
Breast prostheses are being increasingly used, both for cosmetic and reconstructive purposes.10, 11 These procedures, like any other surgery, may be complicated by infections involving the operative area. Although bacteria such as S. aureus and coagulase-negative staphylococci are the most common cause of surgical site infections,1 including cosmetic surgeries such as augmentation mammoplasty,2, 3 this case highlights the emergence of mycobacteria as pathogens associated with breast implant
References (25)
- et al.
Pulmonary disease caused by rapidly growing mycobacteria
Clin Chest Med
(2002) - et al.
Recurrent mycobacterial breast abscesses complicating reconstruction
Br J Plast Surg
(2004) - et al.
What is the impact of breast augmentation on the Breast Screening Programme?
Eur J Surg Oncol
(2003) - et al.
Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee
Am J Infect Control
(1999) - et al.
Microbial evaluation: 139 implants removed from symptomatic patients
Plast Reconstr Surg
(1996) - et al.
Infection due to organsims of the Mycobacterium fortuitum complex after augmentation mammaplasty: Clinical and epidemiologic features
J Infect Dis
(1983) - et al.
Spectrum of disease due to rapidly growing mycobacteria
Rev Infect Dis
(1983) - et al.
Atypical Mycobacterium and breast surgery
Ann Plast Surg
(1995) - et al.
A prosthetic breast implant infected with Mycobacterium fortuitum
Ann Plast Surg
(2000) - et al.
Mycobacterium fortuitum infection in prosthetic breast implants
Plast Reconstr Surg
(2002)