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- W2765683888 abstract "SESSION TITLE: Fungal Infections 2 SESSION TYPE: Affiliate Case Report Poster PRESENTED ON: Tuesday, October 31, 2017 at 01:30 PM - 02:30 PM INTRODUCTION: Mycobacterium abscessus complex are a group of acid-fast Non-Tuberculous Mycobacterium (NTM) that are rapidly growing, multi-drug and disinfectant resistant. Due to its ubiquity in water and soil, infections caused by Mycobacterium abscessus occur by direct inoculation with exposure to infected water or infected material. We herein describe a case of Mycobacterium abscessus in a healthy young female. CASE PRESENTATION: A 42-year-old presented to our hospital with complaints of fever, chills and breast pain. Her pertinent past surgical history includes breast augmentation five years ago. On a trip to the Dominican Republic she had a traumatic event where one of the implants ruptured and both implants needed to be removed. She was placed on oral antibiotics and returned home to New York. Despite antibiotic compliance she had persistent pain and purulent drainage at the surgical site. The abscesses were drained and cultured and she was sent home on empiric antibiotic coverage for common organisms. She returned two weeks later with the same complaints and an acid-fast organism was identified. Cultures of the breast wound was a presumed “fast grower” and amikacin, azithromycin, and meropenem were initiated and the patient was discharged on triple intravenous antibiotics therapy via a peripherally inserted central catheter. After 6 weeks, Mycobacterium abscessus was the result. She returned to the hospital in 8 weeks for surgical debridement. DISCUSSION: With a rise in cosmetic procedures, nosocomial outbreaks and transmission are alarming especially due to the resistance of NTM to disinfectants. Special consideration should be given to cosmetic procedures in that patients are more likely to engage in medical tourism where they schedule a procedure in a different country for financial benefit (1). Due to substandard sterilization techniques that are rampant in developing countries, patients should be aware of the risks of fastidious, multi-drug resistant infections that require antibiotic administration for up 12 months (2). CONCLUSIONS: NTM are a growing concern in both all hosts with prevalence surpassing mycobacterium tuberculosis U.S. and is becoming more prevalent world-wide. Extrapulmonary NTM is becoming a reportable infection in some states in an attempt to confine outbreaks (3). Clinical suspicion as well a rapid initiation of the correct antibiotics are crucial to preventing devastating outcomes from this noxious species. Reference #1: Schnabel D, Esposito DH, Gaines J, et al. Multistate US Outbreak of Rapidly Growing Mycobacterial Infections Associated with Medical Tourism to the Dominican Republic, 2013-2014(1). Emerg Infect Dis 2016;22:1340-7. Reference #2: Gonzalez-Santiago TM, Drage LA. Nontuberculous Mycobacteria: Skin and Soft Tissue Infections. Dermatol Clin 2015;33:563-77. Reference #3: Winthrop KL, Henkle E, Walker A, Cassidy M, Hedberg K, Schafer S. On the Reportability of Nontuberculous Mycobacterial Disease to Public Health Authorities. Ann Am Thorac Soc 2017;14:314-7. DISCLOSURE: The following authors have nothing to disclose: Paul Catella, Shimshon Wiesel, Marco Campitelli, Ambreen Khalil, Priya Tyagi, Mohammad Maruf No Product/Research Disclosure Information" @default.
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- W2765683888 date "2017-10-01" @default.
- W2765683888 modified "2023-09-27" @default.
- W2765683888 title "Bilateral Nontuberculous Mycobacterium Breast Abscesses in a Healthy Young Female: A Devastating Consequence of Breast Augmentation Surgery" @default.
- W2765683888 doi "https://doi.org/10.1016/j.chest.2017.08.177" @default.
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