Guidance on the treatment of rare deep subcutaneous mycobacterium abscess following cosmetic procedures: a case series and systematic review of the literature.

Autor: Rehman, Umar, Hever, Pennylouise, Eiben, Inez, Geh, Jenny
Předmět:
Zdroj: European Journal of Plastic Surgery; Aug2023, Vol. 46 Issue 4, p625-635, 11p
Abstrakt: Background: Mycobacterium abscessus (MA) is a drug-resistant non-tuberculous mycobacterium associated with subcutaneous infections post-cosmetic surgery. It is difficult to diagnose and manage. Case reports of MA following cosmetic procedures have been reported within Asia and South America, but not the UK. Here we report a case series of three patients with a diagnosis of MA infection following a cosmetic procedure performed either abroad or within the UK. We describe their management and perform a review of the literature. Methodology: Patients who had developed MA infections following cosmetic procedures presenting to and treated at a single institute were reviewed. A retrospective review of the patients' records was performed. A systematic review of the literature was performed adhering to PRISMA guidelines. Results: Three patients were identified. None was immunocompromised. All were treated with long-term antibiotics, with 2/3 patients requiring repeated surgical debridement. Systematic review of the literature highlighted 25 articles reported between 2000 and 2022. Seventy-seven patients were treated. The most common antibiotics used were clarithromycin (51.9%, n = 40), amikacin (45.5%, n = 35) and imipenem (18.2%, n = 14). Conclusion: A low index of suspicion for MA infection should be placed in patients who develop subcutaneous lesions post-cosmetic procedures. Infection is associated with a poor response to routine antimicrobials and negative bacterial cultures. Successful management requires a multi-disciplinary approach with input from the Infectious Diseases, Plastic Surgery and Radiological teams. With the rise in cosmetic surgery tourism, early recognition of MA is pertinent to reduce morbidity and healthcare burden from this rare but debilitating complication. Level of evidence: Level V, Therapeutic/Diagnostic. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
Externí odkaz: