Friday, December 11, 2020

Cosmetic surgery and Nontuberculous Mycobacterial infections

There has been an increase in plastic surgery tourism because some countries offer cheap cosmetic surgery. Common surgical procedures sought are breast augmentation surgery, liposuction, eyelid surgery, facelift, labiaplasties, and gluteal lift procedures. [1]
However,  places that offer these surgeries may have inadequate infection control practices (e.g., reuse of equipment or inadequate cleaning and disinfection procedures). This may lead to surgical site infections.
Rapidly growing mycobacteria (RGM) have been associated with postoperative infections in patients undergoing cosmetic surgery procedures. RGM includes the species Mycobacterium abscessus, M. chelonae, and M. fortuitum. [2]

Treatment includes oral therapy with two agents for a minimum of four months. Regimens include two of the following:
Trimethoprim-sulfamethoxazole (1 DS twice daily)
Doxycycline (100 to 200 mg daily)
Levofloxacin (500 mg daily)
Clarithromycin (500 mg twice daily) or azithromycin (250 to 500 mg daily) 

That's all!

[1] Ryan Terrence Pereira, MB, BCh, BAO, Carmel M Malone, MD, Gerard T Flaherty, MD, Aesthetic journeys: a review of cosmetic surgery tourism, Journal of Travel Medicine, Volume 25, Issue 1, 2018, tay042,
[2] 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(8):1340-1347. doi:10.3201/eid2208.151938

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