Mycobacterium Fortuitum infection after abdominoplasty and breast reduction: case report, diagnostic tips and tricks, and overview of the current therapeutic consensus

Mycobacterium Fortuitum infection after abdominoplasty and breast reduction: case report, diagnostic tips and tricks, and overview of the current therapeutic consensus

Author Info

Corresponding Author
Karl Waked
Department of Plastic and Reconstructive Surgery, University Hospital Brussels, Laarbeeklaan 101, 1090 Jette

A B S T R A C T

Background: Surgical site infections caused by non-tuberculous mycobacteria (NTM) are increasingly reported in the literature. Mycobacterium Fortuitum is the one that is most frequently associated with surgical site infections. Case Presentation: We present our first case of Mycobacterium Fortuitum infection after combined abdominoplasty and bilateral breast reduction. Discussion and Conclusions: Diagnosis of NTM-infections remains difficult. Typical symptoms are minor wound dehiscences with the evacuation of clear, odorless fluid collections. The onset can vary between one week to two years postoperatively. A wound dehiscence of a previously closed wound or slow healing of a wound must encourage a prompt diagnosis. A proper amount of fluid collection and/or tissue biopsy are necessary for an accurate diagnosis. Acid-fast or fluorochrome staining are also preferred over classic Gram staining. Treatment consists of proper surgical debridement and long-term, targeted, antibiotic combination therapy. Surgical debridement involves surgical drainage and removal of any infected foreign material. With regards to the antibiotic treatment, a dual antibiotic therapy, consisting of an oral Macrolide with initial parental therapy of Amikacin, is recommended. However, other combinations have been reported and also seem efficacious. An antibiotic treatment of four to six months is advised. The prognosis is usually favorable, although complete healing can sometimes be annoyingly long.

Article Info

Article Type
Case Report
Publication history
Received: Sat 04, May 2019
Accepted: Sat 25, May 2019
Published: Mon 10, Jun 2019
Copyright
© 2023 Karl Waked. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2019.03.06