1
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Liu Y, Chen Y. Surgical Treatment for Cutaneous Mycobacterium abscessus Infection Caused by Injections of Hyaluronic Acid. Clin Cosmet Investig Dermatol 2023; 16:687-692. [PMID: 36969385 PMCID: PMC10038003 DOI: 10.2147/ccid.s394594] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023]
Abstract
Background Facial injection has become popular in aesthetic dermatology. Although injections of these tissue fillers are considered a low-risk procedure, they are not without potentially significant drawbacks. Case Presentation We would like to report a case about cutaneous Mycobacterium abscessus infection after facial injection of hyaluronic acid in China, which obtained satisfactory clinical efficacy by drainage and surgical excision. Conclusion Biological techniques are useful in the diagnosis of cutaneous M. abscessus infection. Surgical excision of skin lesion is effective for cutaneous M. abscessus infection.
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Affiliation(s)
- Yuanzhi Liu
- Department of Medical Cosmetology, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Yongjun Chen
- Department of Medical Cosmetology, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
- Correspondence: Yongjun Chen, Department of Medical Cosmetology, Dermatology Hospital, Southern Medical University, 2 Lujing Road, Yuexiu District, Guangzhou, 523326, Guangdong, People’s Republic of China, Tel/Fax +86 20-87257353, Email
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2
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Cerro-Muñoz P, Navarro-Bielsa A, Almenara-Blasco M, Algara O, Gracia-Cazaña T, Gilaberte Y. Multiresistant Mycobacterium abscessus ulcer treated with photodynamic therapy with methyl-aminolevulinate. Dermatol Ther 2022; 35:e15756. [PMID: 35941060 DOI: 10.1111/dth.15756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/16/2022] [Accepted: 08/02/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | - Alba Navarro-Bielsa
- Department of Dermatology, Miguel Servet University Hospital, Zaragoza, Spain. IIS Aragón, Universidad de Zaragoza
| | | | - Olga Algara
- Department of Microbiology, Miguel Servet University Hospital, Zaragoza, Spain
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3
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Acuña-Chávez LM, Alva-Alayo CA, Aguilar-Villanueva GA, Zavala-Alvarado KA, Alverca-Meza CA, Aguirre-Sánchez MM, Amaya-Castro AA. Bacterial infections in patients with nipple piercings: a qualitative systematic review of case reports and case series. GMS INFECTIOUS DISEASES 2022; 10:Doc03. [PMID: 35463814 PMCID: PMC9006427 DOI: 10.3205/id000080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The main objective of this review is to identify the most frequently isolated bacteria in patients with infections related to nipple piercings in case reports and case series. In addition, the aim is to describe clinical manifestations and antecedents. There is a protocol of this review. The terms "bacterial infections", "nipple piercing" and their synonyms were considered. Pubmed/Medline, Scopus, Embase, Web of Science core collection and Ovid/Medline databases were searched until November 15, 2021 without date or language restrictions. Two authors extracted the articles and three other authors performed the selection, first by title and abstract, and second by full-text revision. Discrepancies were resolved with yet two other authors. Quality was assessed using the Joanna Briggs checklists. Finally, data extraction was realized. A total of 1,531 articles were extracted, of which 20 articles were included, and one article was added by hand-searching. The final number of articles included was 21, all of them with acceptable quality of evidence. Twenty-seven patients were considered (23 women and 4 men), aged between 15-60 years old. The most frequent bacterial genus in case reports and case series was Staphylococcus (n=10), and the most frequent species was M. fortuitum (n=6), although etiology seems to be diverse. The breast was the main affected organ, and the most frequent findings were fluid collection, pain, erythema, granulation tissue and swelling. The suspicion of infection by this bacterial species could be taken into account when it is associated with nipple piercings; however, larger studies are required to give a conclusion based on the evidence.
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Affiliation(s)
- Luis M. Acuña-Chávez
- Facultad de Medicina, Universidad Nacional de Trujillo, Peru,Sociedad Cientifica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Peru,*To whom correspondence should be addressed: Luis M. Acuña-Chávez, Facultad de Medicina, Universidad Nacional de Trujillo, Roma Av. 338, Trujillo, Peru, Phone: +51 939402229, E-mail: ,
| | | | - Giamfranco A. Aguilar-Villanueva
- Facultad de Medicina, Universidad Nacional de Trujillo, Peru,Sociedad Cientifica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Peru
| | - Kevin A. Zavala-Alvarado
- Facultad de Medicina, Universidad Nacional de Trujillo, Peru,Sociedad Cientifica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Peru
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4
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Sindoni A, Valeriani F, Protano C, Liguori G, Romano Spica V, Vitali M, Gallè F. Health risks for body pierced community: a systematic review. Public Health 2022; 205:202-215. [PMID: 35339940 DOI: 10.1016/j.puhe.2022.01.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Body piercing is defined as the penetration of jewellery into openings made in different body areas. In the last decades, it has become increasingly common in the general population. The aim is to analyse the available literature about complications from body piercing for contributing to raise the awareness towards this issue and to plan and perform appropriate prevention interventions. STUDY DESIGN This is a systematic review. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to perform this systematic review; the protocol was registered with PROSPERO [CRD42020177972]. PubMed, Scopus and Web of Science were searched from database inception to April 2020, and articles in English language reporting a proven association between piercings and health risks were included, and their quality were assessed by adequate quality assessment tools. RESULTS A total of 4748 studies were found, and after duplicates removal and screening, 84 articles were included. Studies dealing with microbiological effects reported these complications both locally and at distant sites as a result of the spreading of the primary site infection: mastitis, endocarditis, glomerulonephritis, cephalic tetanus, viral hepatitis, HIV, cerebellar brain abscess and toxic shock syndrome. In addition, bleeding, gingival recession, dental injuries, contact dermatitis, granulomatous dermatitis, keloid, fibroma and basal cell carcinoma were reported. CONCLUSIONS Health authorities should promote educational campaigns to spread the knowledge on health risks related to piercings. Besides, piercers are often not adequately aware of all the possible adverse effects due to piercings because their professional training differs among countries. It is therefore advisable to provide periodical upgrade of their education in this field.
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Affiliation(s)
- A Sindoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy.
| | - F Valeriani
- Department of Movement, Human, and Health Sciences, University of Rome Foro Italico, 00135, Rome, Italy.
| | - C Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy.
| | - G Liguori
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, 80133, Naples, Italy.
| | - V Romano Spica
- Department of Movement, Human, and Health Sciences, University of Rome Foro Italico, 00135, Rome, Italy.
| | - M Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy.
| | - F Gallè
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, 80133, Naples, Italy.
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5
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Costa Morais Oliveira V, Cubas-Vega N, López Del-Tejo P, Baía-da-Silva DC, Araújo Tavares M, Picinin Safe I, Cordeiro-Santos M, Lacerda MVG, Val F. Non-lactational Infectious Mastitis in the Americas: A Systematic Review. Front Med (Lausanne) 2021; 8:672513. [PMID: 34422853 PMCID: PMC8378399 DOI: 10.3389/fmed.2021.672513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/05/2021] [Indexed: 10/29/2022] Open
Abstract
Background: Non-lactational infectious mastitis (NLIM) is an inflammatory breast disease with broad clinical presentation. Inadequate treatment can lead to chronic infections that cause breast deformities. NLIM information is limited, especially in the Americas. A systematic review and meta-analysis have been conducted here. Methods: Literature search was conducted in three databases (Lilacs, PubMed, and Scielo) on NLIM cases in the Americas. Demographic, epidemiological, clinical, radiological, and laboratory data were extracted. The main characteristics and results were also compared according to the country's gross national income. Results: A total of 47 articles were included, resulting in 93 cases. The etiological agent was described in 86 (92.5%) patients. Bacteria were the most prevalent etiology (73; 84.8%). Amongst bacterial diagnoses, more frequent cases were Mycobacterium tuberculosis (28; 38.4%); Corynebacterium spp. (15; 20.5%); non-tuberculous mycobacteria (13; 17.8%). The cases were reported in eight different countries, with the USA being the country with the highest number of cases (35; 37.6%). Patients from high-income countries group presented a shorter diagnostic time when compared to low, low-middle, and upper-middle-income countries. A greater number of radiographic studies with pathological findings were described in high-income countries. Conclusion: Non-lactational infectious mastitis is a complex public health problem with diagnostic and treatment challenges. Hence, multi-professional approach-based additional studies are recommended on its epidemiology, diagnosis, treatment, and control.
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Affiliation(s)
- Victor Costa Morais Oliveira
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Fundação Hospital Adriano Jorge, Manaus, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade Do Estado Do Amazonas, Manaus, Brazil
| | - Nadia Cubas-Vega
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade Do Estado Do Amazonas, Manaus, Brazil
| | - Paola López Del-Tejo
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade Do Estado Do Amazonas, Manaus, Brazil
| | - Djane C Baía-da-Silva
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade Do Estado Do Amazonas, Manaus, Brazil
| | | | | | - Marcelo Cordeiro-Santos
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade Do Estado Do Amazonas, Manaus, Brazil.,Departamento de Ensino e Pesquisa, Universidade Nilton Lins, Manaus, Brazil
| | - Marcus Vinícius Guimarães Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade Do Estado Do Amazonas, Manaus, Brazil.,Rede de Pesquisa em Malária, Instituto Leônidas and Maria Deane, Fiocruz-Amazonas, Manaus, Brazil
| | - Fernando Val
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade Do Estado Do Amazonas, Manaus, Brazil
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6
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Granulomatous Mastitis Due to Non-Tuberculous Mycobacteria: A Diagnostic and Therapeutic Dilemma. Clin Pract 2021; 11:228-234. [PMID: 33919661 PMCID: PMC8167781 DOI: 10.3390/clinpract11020034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 11/16/2022] Open
Abstract
Non-tuberculous mycobacterial (NTM) infections of the breast are rare. These infections present as cellulitis of the breast or breast abscess. Their diagnosis poses a challenge as they manifest signs of acute inflammation, unlike tuberculous mycobacterial infections which present in a chronic pattern. However, on aspiration of pus from the site of infection, primary smear may show acid fast bacilli. This poses a diagnostic dilemma. The present case is that of a 34-year-old woman who presented with recurrent mastitis. She had history of right breast swelling, for which surgical excision had been performed three months prior at another facility. Her histopathology had showed cystic granulomatous neutrophilic mastitis (CNGM). The patient again presented with right breast abscess which was confirmed on ultrasonography. Incision and drainage along with removal of necrotic tissue was done. Primary smear of pus showed acid fast bacilli on Ziehl-Neelson staining. Bacterial culture and line probe speciation revealed non-tuberculous mycobacterium M. abscessus, which responded well to prolonged anti-microbial therapy. These rapidly growing NTM require prolonged treatment and are quite often recurrent. M. abscessus is a rare cause of CNGM, with this being only the third reported case in literature. A brief case report with a review of literature is presented.
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7
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van der Loo C, Bartie C, Barnard TG, Potgieter N. Detection of Free-Living Amoebae and Their Intracellular Bacteria in Borehole Water before and after a Ceramic Pot Filter Point-of-Use Intervention in Rural Communities in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3912. [PMID: 33917870 PMCID: PMC8068299 DOI: 10.3390/ijerph18083912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/26/2021] [Accepted: 04/02/2021] [Indexed: 11/21/2022]
Abstract
Free-living amoebae (FLA) are ubiquitous in nature, whereas amoeba-resistant bacteria (ARB) have evolved virulent mechanisms that allow them to resist FLA digestion mechanisms and survive inside the amoeba during hostile environmental conditions. This study assessed the prevalence of FLA and ARB species in borehole water before and after a ceramic point-of-use intervention in rural households. A total of 529 water samples were collected over a five-month period from 82 households. All water samples were subjected to amoebal enrichment, bacterial isolation on selective media, and molecular identification using 16S PCR/sequencing to determine ARB species and 18S rRNA PCR/sequencing to determine FLA species present in the water samples before and after the ceramic pot intervention. Several FLA species including Acanthamoeba spp. and Mycobacterium spp. were isolated. The ceramic pot filter removed many of these microorganisms from the borehole water. However, design flaws could have been responsible for some FLA and ARB detected in the filtered water. FLA and their associated ARB are ubiquitous in borehole water, and some of these species might be potentially harmful and a health risk to vulnerable individuals. There is a need to do more investigations into the health risk of these organisms after point-of-use treatment.
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Affiliation(s)
- Clarissa van der Loo
- Water and Health Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa; (C.v.d.L.); (T.G.B.)
| | | | - Tobias George Barnard
- Water and Health Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa; (C.v.d.L.); (T.G.B.)
| | - Natasha Potgieter
- Environmental Health, Domestic Hygiene and Microbial Pathogens Research Group, Department of Microbiology, University of Venda, Thohoyandou 1950, South Africa
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8
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Li XQ, Wu HL, Yuan JP, Liu TG, Sun SR, Chen C. Bacteria Associated with Granulomatous Lobular Mastitis and the Potential for Personalized Therapy. J INVEST SURG 2020; 35:164-170. [PMID: 33059500 DOI: 10.1080/08941939.2020.1833262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Granulomatous lobular mastitis (GLM), also known as idiopathic granulomatous mastitis (IGM), is a chronic inflammatory lesion of the breast. The incidence of GLM has been increasing in recent years, especially among young women. The etiologies of GLM have not been fully elucidated but are associated with autoimmunity and bacterial infection. Bacteria, especially Corynebacterium species, play important roles in GLM. In this article, we review research progress regarding the bacteriology of GLM attained with the application of several new high-throughput detection techniques. Accurate detection might be important for deepening our understanding of the pathogenesis of GLM and hold promise for personalized GLM therapy.
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Affiliation(s)
- Xin-Qian Li
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Hong-Li Wu
- Department of Breast Surgery, People's Hospital of Ningxia Autonomous Region, Yinchuan, Ningxia, PR China
| | - Jing-Ping Yuan
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Tian-Gang Liu
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education and School of Pharmaceutical Sciences, Wuhan University, Wuhan, China
| | - Sheng-Rong Sun
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
| | - Chuang Chen
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China
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9
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Sardiña LA, Kaw U, Jour G, Knabel D, Dyck RM, Procop GW, Bergfeld WF, Harrington S, Demkowicz R, Piliang MP. Diagnosis of Mycobacterium abscessus/chelonae complex cutaneous infection: Correlation of tissue culture and skin biopsy. J Cutan Pathol 2019; 47:321-327. [PMID: 31804711 DOI: 10.1111/cup.13623] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 10/06/2019] [Accepted: 11/15/2019] [Indexed: 01/05/2023]
Abstract
Mycobacterium abscessus and M. chelonae belong to the rapid-growing nontuberculous mycobacteria (NTM) group, which are defined by their ability to form visible colonies on agar within 7 days of subculture. Cutaneous infections by this complex show a heterogeneous clinical presentation with varied histopathologic findings. However, the presence of vacuoles in many specimens has been reported as a specific histologic finding. Herein, we correlate the histopathology of patients with tissue-culture positive M. abscessus/M. chelonae complex in order to identify features that may prompt a rapid categorization of the infectious etiology. The cohort includes 33 skin punch biopsy specimens from 28 patients who had associated positive tissue cultures. The most frequent clinical presentation was a single or multiple nodule. Twenty-seven specimens (81.81%) were found to have vacuoles. The observation of certain histologic features (ie, polymorphonuclear microabscesses and epithelioid granuloma formation) should raise the possibility of infection by NTM. In addition to these findings, we believe the presence of vacuoles in the dermal and subcutaneous inflammation should raise suspicion for NTM.
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Affiliation(s)
- Luis A Sardiña
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Urvashi Kaw
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - George Jour
- Department of Pathology and Dermatology, New York Langone Medical Center, New York, New York
| | - Daniel Knabel
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Rayna M Dyck
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio.,Skin Wellness Center Of Alabama, Birmingham, Alabama
| | - Gary W Procop
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Wilma F Bergfeld
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Susan Harrington
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Ryan Demkowicz
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Melissa P Piliang
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
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10
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Joseph C, Petit C, Schmit JL, Drancourt M, Pluquet E, Lanoix JP. Community-acquired granulomatous mastitis superinfected with Mycobacterium bolletii. Med Mal Infect 2019; 50:291-292. [PMID: 31806269 DOI: 10.1016/j.medmal.2019.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/04/2019] [Indexed: 11/25/2022]
Affiliation(s)
- C Joseph
- Infectious Diseases Department, University Hospital, Amiens, France; AGIR: Microbiology Research Unit, EA4294, Jules Verne University of Picardie, Amiens, France.
| | - C Petit
- Infectious Diseases Department, University Hospital, Amiens, France
| | - J L Schmit
- Infectious Diseases Department, University Hospital, Amiens, France; AGIR: Microbiology Research Unit, EA4294, Jules Verne University of Picardie, Amiens, France
| | - M Drancourt
- Microbiology Laboratory, Hygiene, Hospital Epidemiology, La Timone Hospital, University Hospital, Marseille, France
| | - E Pluquet
- Bacteriology Laboratory, University Hospital, Amiens, France; AGIR: Microbiology Research Unit, EA4294, Jules Verne University of Picardie, Amiens, France
| | - J P Lanoix
- Infectious Diseases Department, University Hospital, Amiens, France; AGIR: Microbiology Research Unit, EA4294, Jules Verne University of Picardie, Amiens, France
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11
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Rominski A, Schulthess B, Müller DM, Keller PM, Sander P. Effect of β-lactamase production and β-lactam instability on MIC testing results for Mycobacterium abscessus. J Antimicrob Chemother 2018; 72:3070-3078. [PMID: 28961987 DOI: 10.1093/jac/dkx284] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 07/09/2017] [Indexed: 12/27/2022] Open
Abstract
Objectives Limited treatment options available for Mycobacterium abscessus infections include the parenteral β-lactam antibiotics cefoxitin and imipenem, which show moderate in vitro activity. Other β-lactam antibiotics (except meropenem) have no considerable in vitro activity, due to their rapid hydrolysis by a broad-spectrum β-lactamase (Bla_Mab). We here addressed the impact of β-lactamase production and β-lactam in vitro stability on M. abscessus MIC results and determined the epidemiological cut-off (ECOFF) values of cefoxitin, imipenem and meropenem. Methods By LC high-resolution MS (LC-HRMS), we assessed the in vitro stability of cefoxitin, imipenem and meropenem. M. abscessus ATCC 19977 strain and its isogenic blaMab deletion mutant were used for MIC testing. Based on MIC distributions for M. abscessus clinical strains, we determined ECOFFs of cefoxitin, imipenem and meropenem. Results A functional Bla_Mab increased MICs of penicillins, ceftriaxone and meropenem. LC-HRMS data showed significant degradation of cefoxitin, imipenem and meropenem during standard antibiotic susceptibility testing procedures. MIC, MIC50 and ECOFF values of cefoxitin, imipenem and meropenem are influenced by incubation time. Conclusions The results of our study support administration of imipenem, meropenem and cefoxitin, for treatment of patients infected with M. abscessus. Our findings on in vitro instability of imipenem, meropenem and cefoxitin explain the problematic correlation between in vitro susceptibility and in vivo activity of these antibiotics and question the clinical utility of susceptibility testing of these chemotherapeutic agents.
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Affiliation(s)
- Anna Rominski
- Institut für Medizinische Mikrobiologie, Universität Zürich, Gloriastrasse 30/32, 8006 Zürich, Switzerland
| | - Bettina Schulthess
- Institut für Medizinische Mikrobiologie, Universität Zürich, Gloriastrasse 30/32, 8006 Zürich, Switzerland.,Nationales Zentrum für Mykobakterien, Gloriastrasse 30/32, 8006 Zürich, Switzerland
| | - Daniel M Müller
- Institut für Klinische Chemie, UniversitätsSpital Zürich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Peter M Keller
- Institut für Medizinische Mikrobiologie, Universität Zürich, Gloriastrasse 30/32, 8006 Zürich, Switzerland.,Nationales Zentrum für Mykobakterien, Gloriastrasse 30/32, 8006 Zürich, Switzerland
| | - Peter Sander
- Institut für Medizinische Mikrobiologie, Universität Zürich, Gloriastrasse 30/32, 8006 Zürich, Switzerland.,Nationales Zentrum für Mykobakterien, Gloriastrasse 30/32, 8006 Zürich, Switzerland
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12
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Breuner CC, Levine DA, Breuner CC, Alderman EM, Garofalo R, Grubb LK, Powers ME, Upadhya KK, Wallace SB. Adolescent and Young Adult Tattooing, Piercing, and Scarification. Pediatrics 2017; 140:peds.2017-1962. [PMID: 28924063 DOI: 10.1542/peds.2017-1962] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Tattoos, piercing, and scarification are now commonplace among adolescents and young adults. This first clinical report from the American Academy of Pediatrics on voluntary body modification will review the methods used to perform the modifications. Complications resulting from body modification methods, although not common, are discussed to provide the pediatrician with management information. Body modification will be contrasted with nonsuicidal self-injury. When available, information also is presented on societal perceptions of body modification.
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Affiliation(s)
- Cora C. Breuner
- Adolescent Medicine Division, Department of Pediatrics, Orthopedics and Sports Medicine, Seattle Children’s Hospital, University of Washington, Seattle, Washington; and
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13
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Al-Momani H, Perry A, Jones R, Bourke S, Doe S, Perry J, Anderson A, Forrest T, Forrest I, Griffin M, Brodlie M, Pearson J, Ward C. Nontuberculous mycobacteria in gastrostomy fed patients with cystic fibrosis. Sci Rep 2017; 7:46546. [PMID: 28436419 PMCID: PMC5402269 DOI: 10.1038/srep46546] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 03/22/2017] [Indexed: 11/09/2022] Open
Abstract
Multi-drug resistant Mycobacterium abscessus complex (MABSC) is a form of Nontuberculous mycobacteria (NTM) of special, international concern in Cystic Fibrosis (CF). We hypothesised that gastric juice and percutaneous endoscopic gastrostomy (PEG) feeding devices might yield MABSC isolates. Gastric juice and sputa from sixteen adult PEG fed CF patients and five replaced PEG tubes were studied. Bacterial and fungal isolates were cultured. Mycobacterium were identified by rpoB, sodA and hsp65 gene sequencing and strain typed using variable number tandem repeat. Bacteria and/or fungi grew from all gastric juice, sputa and PEG samples. MABSC were detected in 7 patients. Five had MABSC in their sputum. Two had an identical MABSC strain in their sputum and gastric juice and one had the same strain isolated from their PEG tube and sputum. Two patients who were sputum sample negative had MABSC isolated in their gastric juice or PEG tube. MABSC were therefore identified for the first time from a gastric sample in a minority of patients. We conclude that gastric juice and PEG-tubes may be a potential source of MABSC isolates in CF patients, and these findings warrant further study.
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Affiliation(s)
- H Al-Momani
- Institutes of Cellular Medicine and Cell &Molecular Biosciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - A Perry
- Department of Microbiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK
| | - R Jones
- Institutes of Cellular Medicine and Cell &Molecular Biosciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - S Bourke
- Adult Cystic Fibrosis Centre and Northern Oesophago-Gastric Unit Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - S Doe
- Adult Cystic Fibrosis Centre and Northern Oesophago-Gastric Unit Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - J Perry
- Department of Microbiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK
| | - A Anderson
- Adult Cystic Fibrosis Centre and Northern Oesophago-Gastric Unit Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - T Forrest
- Adult Cystic Fibrosis Centre and Northern Oesophago-Gastric Unit Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - I Forrest
- Adult Cystic Fibrosis Centre and Northern Oesophago-Gastric Unit Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - M Griffin
- Adult Cystic Fibrosis Centre and Northern Oesophago-Gastric Unit Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - M Brodlie
- Institutes of Cellular Medicine and Cell &Molecular Biosciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - J Pearson
- Institutes of Cellular Medicine and Cell &Molecular Biosciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - C Ward
- Institutes of Cellular Medicine and Cell &Molecular Biosciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
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14
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Granulomatous Lobular Mastitis Associated with Mycobacterium abscessus in South China: A Case Report and Review of the Literature. Case Rep Infect Dis 2017; 2017:7052908. [PMID: 28286681 PMCID: PMC5329686 DOI: 10.1155/2017/7052908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/17/2017] [Indexed: 11/17/2022] Open
Abstract
Mycobacteria, which are known as rapidly growing bacteria, are pathogens that are responsible for cutaneous or subcutaneous infections that especially occur after injection, trauma, or surgery. In this report, we describe a species of Mycobacterium abscessus that was isolated from a breast abscess in a patient who was previously diagnosed with granulomatous lobular mastitis (GLM). This current case is the first ever presented case of GLM associated with M. abscessus documented in South China. The case presentation highlights the role of M. abscessus in GLM. The association of M. abscessus and GLM is discussed and a summary of breast infection due to Mycobacteria is given.
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15
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Rominski A, Roditscheff A, Selchow P, Böttger EC, Sander P. Intrinsic rifamycin resistance ofMycobacterium abscessusis mediated by ADP-ribosyltransferase MAB_0591. J Antimicrob Chemother 2016; 72:376-384. [DOI: 10.1093/jac/dkw466] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/29/2016] [Accepted: 10/03/2016] [Indexed: 11/14/2022] Open
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16
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Castillo M, Sanjuán A, Pérez N, Zanón G, Bons N, Vilanova M, Vanrell JA, Merino MJ, Fernández PL. Fibrous Histiocytoma-like Spindle-Cell Proliferation in the Nipple After Body-Piercing. Int J Surg Pathol 2016; 14:89-93. [PMID: 16501844 DOI: 10.1177/106689690601400118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report the case of a 19-year-old pregnant woman who presented with a nipple tumor. The lesion consisted in a spindle-cell proliferation with histologic features similar to those of fibrous histiocytoma, with a highly vascularized stroma. Although it showed low mitotic activity, scattered marked atypical cells with prominent nucleoli were identified, thus raising concern about the benign nature of the tumor. Immunohistochemical evaluation revealed that the spindle cells were diffusely positive for vimentin, focally positive for CD68, and negative for all the other tested antibodies. The patient had a total excision of the lesion and she is free of disease after 30 months. To our knowledge this is the first reported case of a lesion of this type in the nipple after body-piercing.
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MESH Headings
- Adult
- Antigens, CD/analysis
- Antigens, Differentiation, Myelomonocytic/analysis
- Body Piercing/adverse effects
- Breast Neoplasms/chemistry
- Breast Neoplasms/diagnosis
- Breast Neoplasms/etiology
- Breast Neoplasms/pathology
- Cell Proliferation
- Female
- Histiocytoma, Benign Fibrous/chemistry
- Histiocytoma, Benign Fibrous/diagnosis
- Histiocytoma, Benign Fibrous/etiology
- Histiocytoma, Benign Fibrous/pathology
- Humans
- Immunohistochemistry
- Nipples/chemistry
- Nipples/pathology
- Nipples/surgery
- Pregnancy
- Pregnancy Complications, Neoplastic/diagnosis
- Pregnancy Complications, Neoplastic/etiology
- Pregnancy Complications, Neoplastic/pathology
- Vimentin/analysis
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Affiliation(s)
- M Castillo
- Department of Gynecology & Obstetrics, Hospital Clínic, University of Barcelona, Andorra, Spain
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17
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Sousa PPD, Cruz RCDS, Schettini APM, Westphal DC. Mycobacterium abscessus skin infection after tattooing--Case report. An Bras Dermatol 2016; 90:741-3. [PMID: 26560222 PMCID: PMC4631242 DOI: 10.1590/abd1806-4841.20153362] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 01/27/2014] [Indexed: 11/23/2022] Open
Abstract
Mycobacterium abscessus is a rapidly growing mycobacterium that has
been affecting people undergoing invasive procedures, such as videosurgery and
mesotherapy. This bacterium has global distribution, being found in numerous niches.
The frequency of published reports of infection by rapidly growing mycobacteria
associated with tattooing procedures has increased in recent years. However, in
Brazil there were no case reports of M. abscessus after tattooing in the literature
until now. In this paper, we describe the case of a patient with a nine-month history
of lesion on a tattoo site. The diagnosis of infection with Mycobacterium
abscessus was established by correlation between dermatological and
histopathological aspects, culture and molecular biology techniques. The patient had
significant improvement of symptoms with the use of clarithromycin monotherapy.
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18
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Wong SSY, Wong SCY, Yuen KY. Infections associated with body modification. J Formos Med Assoc 2012; 111:667-81. [PMID: 23265745 DOI: 10.1016/j.jfma.2012.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 10/10/2012] [Accepted: 10/25/2012] [Indexed: 10/27/2022] Open
Abstract
Although exact statistics are lacking, body modifications for cosmetic purposes are performed in many countries. The commonest forms include tattooing, body piercing, and breast and facial augmentation using implants or injectable fillers. Liposuction and, to a lesser extent, mesotherapy are also practiced in many countries. Infective complications of these procedures include local infections, transmission of bloodborne pathogens (viral hepatitis and human immunodeficiency virus), and distant infections such as infective endocarditis. Presence of foreign bodies, long healing time of piercing wounds, and poor compliance with infection control practices of some practitioners all predispose the recipients to infections. Apart from the endogenous microbial flora of the skin and mucosae, atypical mycobacteria, especially the rapid growers, have emerged as some of the most important pathogens in such settings. Outbreaks of infection are commonly reported. We hereby review the current knowledge of the topic with specific focus on infections associated with tattooing, body piercing, breast augmentation, mesotherapy, liposuction, and tissue filler injections. Greater awareness among consumers and health-care professionals, as well as more stringent regulations by the health authorities, is essential to minimize the health risks arising from these procedures.
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Affiliation(s)
- Samson Sai-Yin Wong
- Department of Microbiology, Research Centre for Infection and Immunology, Faculty of Medicine, The University of Hong Kong, Hong Kong
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19
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Mycobacterium fortuitum Breast Infection After Nipple Ring Placement. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2012. [DOI: 10.1097/ipc.0b013e318255d530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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[Skin and soft tissue infections due to non-tuberculous mycobacteria: etiology, epidemiology, pathogenesis, differential diagnostic aspects and therapeutic recommendations]. Wien Med Wochenschr 2012; 161:426-32. [PMID: 22016064 DOI: 10.1007/s10354-011-0027-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 08/09/2011] [Indexed: 10/16/2022]
Abstract
Non-tuberculous mycobacteria are rarely responsible for skin and soft tissue infections. These infections are caused by different mycobacterial species originating from the environment (water, soil, plants, and animals). Various factors influence the clinical manifestation of the cutaneous infection: the immunological situation of the patient, the degree of cutaneous impairment, and the extent of the contact with the contaminated environment. The clinical manifestation is non-specific and often the cause of extensive diagnostic activities. The diagnosis is based on the cultural detection of the causative pathogen. The management of these skin and subcutaneous infections is a challenge for each physician. The treatment comprises administration of several antibiotics and antituberculosis drugs for many months. Surgical procedures are necessary in some patients.
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21
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Yasar KK, Pehlivanoglu F, Sengoz G, Cabioglu N. Successfully treated Mycobacterium abscessus mastitis: a rare cause of breast masses. Indian J Med Microbiol 2012; 29:425-7. [PMID: 22120809 DOI: 10.4103/0255-0857.90187] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Rapidly growing mycobacteria are pathogens responsible for cutaneous or subcutaneous infections especially occurring after injection, trauma or surgery. We describe a patient with Mycobacterium abscessus mastitis that presented as a mass lesion and haemorrhagical discharge. It was initially diagnosed and treated as fibrocystic disease and non-specific abscess. Full recovery was obtained with combination therapy of clarithromycin, linezolid and amikacin without surgical debridement followed by several abscess aspirations. Atypical mycobacteria should be considered in diagnosis of chronic breast lesions in endemic areas. This is the first reported case of mastitis due to M. abscessus in Turkey.
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Affiliation(s)
- K K Yasar
- Department of Clinical Microbiology and Infectious Diseases, Haseki Training and Research Hospital, Adnan Adivar Cad. Aksaray, Istanbul 343, Turkey.
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22
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Abstract
Body and earlobe piercing are common practices in the USA today. Minor complications including infection and bleeding occur frequently and, although rare, major complications have been reported. Healthcare professionals should be cognizant of the medical consequences of body piercing. Complications vary depending on the body-piercing site, materials used, experience of the practitioner, hygiene regimens, and aftercare by the recipient. Localized infections are common. Systemic infections such as viral hepatitis and toxic shock syndrome and distant infections such as endocarditis and brain abscesses have been reported. Other general complications include allergic contact dermatitis (e.g. from nickel or latex), bleeding, scarring and keloid formation, nerve damage, and interference with medical procedures such as intubation and blood/organ donation. Site-specific complications have been reported. Oral piercings may lead to difficulty speaking and eating, excessive salivation, and dental problems. Oral and nasal piercings may be aspirated or become embedded, requiring surgical removal. Piercing tracts in the ear, nipple, and navel are prone to tearing. Galactorrhea may be caused by stimulation from a nipple piercing. Genital piercings may lead to infertility secondary to infection, and obstruction of the urethra secondary to scar formation. In men, priapism and fistula formation may occur. Women who are pregnant or breastfeeding and have a piercing or are considering obtaining one need to be aware of the rare complications that may affect them or their child. Though not a 'complication' per se, many studies have reported body piercing as a marker for high-risk behavior, psychopathologic symptoms, and anti-social personality traits. When it comes to piercing complications, prevention is the key. Body piercers should take a complete medical and social history to identify conditions that may predispose an individual to complications, and candidates should choose a qualified practitioner to perform their piercing. As body piercing continues to be popular, understanding the risks of the procedures as well as the medical and psychosocial implications of wearing piercing jewelry is important for the medical practitioner.
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Affiliation(s)
- Jaimee Holbrook
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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23
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Monego F, Duarte RS, Nakatani SM, Araújo WN, Riediger IN, Brockelt S, Souza V, Cataldo JI, da Silva Dias RC, Biondo AW. Molecular identification and typing of Mycobacterium massiliense isolated from postsurgical infections in Brazil. Braz J Infect Dis 2011; 15:436-41. [DOI: 10.1016/s1413-8670(11)70224-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 06/29/2011] [Indexed: 10/27/2022] Open
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24
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Abstract
This article describes some of the miscellaneous etiologies of pediatric chest pain that are important to recognize early and diagnose. Up to 45% of pediatric chest pain cases may elude definitive diagnosis. Serious morbidity or mortality is infrequent. Accurate diagnosis of more obscure causes may help to avoid unnecessary emergency department evaluation and cardiology referral, while also alleviating the concern and stress families and patients experience when dealing with chest pain.
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Affiliation(s)
- Stephen John Cico
- Division of Emergency Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, M/S B-5520, 4800 Sand Point Way North East, Seattle, WA 98105, USA.
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25
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Breast abscess following nipple piercing: a case report and review of the literature. Arch Gynecol Obstet 2010; 282:623-6. [DOI: 10.1007/s00404-010-1560-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2010] [Accepted: 06/09/2010] [Indexed: 10/19/2022]
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26
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Kluger N, Guillot B. Complications des piercings. Ann Dermatol Venereol 2010; 137:153-8. [DOI: 10.1016/j.annder.2009.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Accepted: 09/13/2009] [Indexed: 10/20/2022]
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27
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Giuliana B, Loredana S, Pasquale S, Giovanna P, Giorgio C, Laura C, Pellegrino A, Paolo N, Luigi C, Massimo A. Complication of nasal piercing by Staphylococcus aureus endocarditis: a case report and a review of literature. CASES JOURNAL 2010; 3:37. [PMID: 20205910 PMCID: PMC2828432 DOI: 10.1186/1757-1626-3-37] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Accepted: 01/25/2010] [Indexed: 11/25/2022]
Abstract
Body piercing, a growing trend especially in young people, is often complicated by severe infections. We present a case of acute bacterial endocarditis by Staphylococcus aureus complicated by multiple cerebral, kidney, spleen embolisms in a young girl, with no known previous cardiac abnormalities, following the piercing of nasal septum. This case highlights the importance of education of patients with and without structural heart disease to the potential dangerous and even life threatening infectious complications of piercing, and stimulate further discussion on the possibility of antibiotic prophylaxis of such procedures.
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Affiliation(s)
- Battagin Giuliana
- Department of Clinical Infectious Diseases and Cardiac Surgery, Tor Vergata University Hospital, V, Montpellier 1, 00133, Rome, Italy.
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28
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Pasticci MB, Lapalorcia LM, Antonini G, Mencacci A, Mazzolla R, Baldelli F. Community-acquired mastitis due to Mycobacterium abscessus: a case report. J Med Case Rep 2009; 3:130. [PMID: 20062768 PMCID: PMC2803802 DOI: 10.1186/1752-1947-3-130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2008] [Accepted: 11/17/2009] [Indexed: 11/12/2022] Open
Abstract
Introduction Mycobacterium abscessus is a rapidly growing mycobacterium usually causing skin and soft tissue infections in immunocompetent patients following contaminated traumatic or surgical wounds or contaminated injected medications. Disseminated infections and pulmonary infections are usually reported in immunocompromised hosts. Case presentation We describe a 54-year-old Caucasian woman with mastitis due to M. abscessus. A few days after clinical evidence of mastitis, the patient was started on broad-spectrum antibiotics. Subsequently, due to persistence of symptoms, a percutaneous breast biopsy was performed followed by surgical drainage. Initial cultures failed to grow micro-organisms and tissue histology showed chronic inflammatory reaction with giant cells. Several days after surgery, her symptoms recurred. Finally, M. abscessus breast infection was diagnosed and the patient was treated successfully. Conclusion Rapidly growing mycobacteria need to be included in the differential diagnosis of patients with chronic mastitis having pus discharge and who do not respond to broad-spectrum antibiotics.
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Affiliation(s)
- Maria Bruna Pasticci
- Infectious Disease Section, Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Perugia, Italy
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29
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Sadove R, Clayman MA. Surgical procedure for reversal of nipple piercing. Aesthetic Plast Surg 2008; 32:563-5. [PMID: 18389303 DOI: 10.1007/s00266-008-9140-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2007] [Accepted: 12/27/2007] [Indexed: 12/01/2022]
Abstract
Body piercing of the nipples for adornment with jewelry has increased worldwide. Many patients later regret their decision and request reversal along with a desire to maintain their ability to breast feed. The surgeon must remove the epithelial tunnel with minimum damage to adjacent ducts. The simple technique described uses the patient's jewelry post as a guide and a common disposable biopsy punch. Slid over the post, the punch excises the epithelial tunnel core with minimal harm to surrounding structures.
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Affiliation(s)
- R Sadove
- Division of Plastic and Reconstructive Surgery, University of Florida, P.O. Box 100286, Gainesville, FL 32610, USA.
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30
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Bengualid V, Singh V, Singh H, Berger J. Mycobacterium fortuitum and anaerobic breast abscess following nipple piercing: case presentation and review of the literature. J Adolesc Health 2008; 42:530-2. [PMID: 18407050 DOI: 10.1016/j.jadohealth.2007.10.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Revised: 10/25/2007] [Accepted: 10/30/2007] [Indexed: 11/26/2022]
Abstract
PURPOSE Body piercing has become increasingly prevalent. We describe a case of breast infection with combined mycobacteria and anaerobe following nipple piercing, and review the literature. CASE A 17-year-old female developed a breast abscess 4 months after nipple piercing. Cultures grew Prevotalla melangenica and Mycobacterium fortuitum. She required drainage and antibiotic treatment. Three months into her treatment she stopped her medications, relapsed, and required drainage. Two months later, on antimycobacteria therapy, her wound is healing. DISCUSSION Review of the infectious complications of nipple piercing yielded 12 cases, 5 of which had a foreign body. The pathogens isolated (coagulase negative staphylococcus, mycobacteria, streptococcus, anaerobe, and gordonia) are not the usual organisms to be isolated from a breast abscess. This could result from reporting bias or the presence of a foreign body, the nipple ring. The three cases of mycobacteria, in addition to ours, are reviewed. The average age is 22 years. Three to 9 months elapsed between piercing and infection. All cases required drainage. Antimycobacteria therapy was used in three of the four cases for 10 days to 6 months. CONCLUSION With the increasing prevalence of body piercing, it is important to document and report infections. We describe a breast abscess following nipple piercing with combined anaerobic and a mycobacterial pathogens. This underscores the need for obtaining cultures including anaerobes and mycobacteria.
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Affiliation(s)
- Victoria Bengualid
- St. Barnabas Hospital, Department of Infectious Diseases, Bronx, New York 10457, USA.
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31
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Abstract
Recently, piercing and tattooing have gained increasing popularity worldwide, through all social classes and age groups. Besides pierced ear lobes, piercing of the tongue, nose, nipples, belly button, and even the genitals is quite common. The variety of tattoos range from temporary henna tattoos to permanent makeup and permanent tattoos, where the pigments are deposed in the dermis. These trends are supplemented by more invasive methods of body modification such as implanting, scarification, or branding. Parallel with the increasing popularity of piercing and tattoos, the knowledge about associated complications rose. Complications depend substantially on the circumstances in which body modifications are applied, the materials used, and the body region concerned. This article gives an overview of the most common complications of body modification methods, which mainly result from shortcomings in the application itself or in hygiene regimens. Consequences may be as severe as life-threatening events or permanent malfunction of different organs.
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32
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Abstract
Body piercing is a growing trend, especially in young people, but the literature on complications of piercing consists mostly of case reports involving ear piercing. Previous reported complications of piercing include contact dermatitis, keloids, traumatic tearing, viral transmission, and bacterial infections. We report two patients who presented with atypical mycobacterial infections of body piercing sites. It is important to recognize the association of piercing and mycobacterial infections so that tissue can be obtained for histopathologic examination and appropriate culture.
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Affiliation(s)
- Tammie Ferringer
- Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania 17822, USA.
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33
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34
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Adékambi T, Ben Salah S, Khlif M, Raoult D, Drancourt M. Survival of environmental mycobacteria in Acanthamoeba polyphaga. Appl Environ Microbiol 2006; 72:5974-81. [PMID: 16957218 PMCID: PMC1563627 DOI: 10.1128/aem.03075-05] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2005] [Accepted: 06/16/2006] [Indexed: 11/20/2022] Open
Abstract
Free-living amoebae in water are hosts to many bacterial species living in such an environment. Such an association enables bacteria to select virulence factors and survive in adverse conditions. Waterborne mycobacteria (WBM) are important sources of community- and hospital-acquired outbreaks of nontuberculosis mycobacterial infections. However, the interactions between WBM and free-living amoebae in water have been demonstrated for only few Mycobacterium spp. We investigated the ability of a number (n = 26) of Mycobacterium spp. to survive in the trophozoites and cysts of Acanthamoeba polyphaga. All the species tested entered the trophozoites of A. polyphaga and survived at this location over a period of 5 days. Moreover, all Mycobacterium spp. survived inside cysts for a period of 15 days. Intracellular Mycobacterium spp. within amoeba cysts survived when exposed to free chlorine (15 mg/liter) for 24 h. These data document the interactions between free-living amoebae and the majority of waterborne Mycobacterium spp. Further studies are required to examine the effects of various germicidal agents on the survival of WBM in an aquatic environment.
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Affiliation(s)
- Toïdi Adékambi
- Unité des Rickettsies, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
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35
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Abstract
Nontuberculous mycobacteria can cause cutaneous infections in both children and adults. Localized nontuberculous mycobacterial infections of the skin have been reported in children following injections or surgical procedures. We report a child who developed a cutaneous nontuberculous mycobacterial infection after exposure of a skin wound to pond water. Cutaneous infection with the rapidly growing mycobacteria Mycobacterium abscessus was demonstrated by clinical and histologic evaluation on the lower leg of an otherwise healthy 12-year-old Caucasian boy. We describe this as an instance of an unusual acquisition of cutaneous M. abscessus infection in a child.
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36
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Lewis CG, Wells MK, Jennings WC. Mycobacterium fortuitum breast infection following nipple-piercing, mimicking carcinoma. Breast J 2005; 10:363-5. [PMID: 15239798 DOI: 10.1111/j.1075-122x.2004.21393.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We reviewed a rare breast infection occurring 4 months after nipple piercing. Clinical examination suggested carcinoma. Mycobacterium fortuitum was eventually isolated after surgical biopsy and debridement. Antibiotic therapy was initiated intravenously using two drugs and oral therapy was continued for 6 months. A contralateral mycobacterial lesion emerged and was excised along with a residual fibrotic nodule at the original biopsy site. When adequate sampling of a complex and suspicious breast mass is benign and initial bacterial cultures are sterile, mycobacterial infection should be considered, particularly when there is a history of previous nipple piercing procedures.
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Affiliation(s)
- Chris G Lewis
- Department of Surgery, University of Oklahoma College of Medicine, Tulsa, Oklahoma
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37
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Caliendo C, Armstrong ML, Roberts AE. Self-reported characteristics of women and men with intimate body piercings. J Adv Nurs 2005; 49:474-84. [PMID: 15713179 DOI: 10.1111/j.1365-2648.2004.03320.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The purpose of this paper is to report the findings of a study exploring factors associated with female and male intimate body piercing, with particular emphasis on health issues. BACKGROUND Nipple and genital piercings (intimate piercings) have become common types of body art. Scant medical and nursing literature is available, leading to little understanding of these body modifications by health care providers. METHOD A convenience sample of intimately pierced individuals (63 women and 83 men) from 29 states in the United States of America was surveyed via an author-developed questionnaire. Questions focused on demographic characteristics, decision factors and health problems related to intimate piercings. Self-reported characteristics were compared between female and male participants, and participants were compared demographically to United States general population. RESULTS Participants reported wearing nipple piercings (43%), genital piercings (25%) and both types (32%). Respondents were significantly younger, less ethnically diverse, better educated, less likely to be married, more often homosexual or bisexual and they initiated sexual activity at a younger age than the US population. Deliberate, individual decisions for procurement of the intimate piercings were made. Average purchase consideration was at age 25 (nipple) and 27 (genital); average age to obtain the piercing was 27 (nipple) and 28 (genital) years. Purposes for obtaining the piercings included uniqueness, self-expression and sexual expression. Most participants still liked their piercing (73-90%). Health concerns related to intimate piercings were described by both those with nipple piercings (66%) and with genital piercings (52%) and included site sensitivity, skin irritation, infection and change in urinary flow (male genital). Few STDs (3%) were reported and no HIV or hepatitis. Usually non-medical advice was sought for problems -- often from the body piercer. CONCLUSIONS Understanding client rationale is not a necessary prerequisite for providing quality patient care; however, awareness of purposes and decision-making in intimate piercing can help nurses to be sensitive to client needs and plan appropriate health education.
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Affiliation(s)
- Carol Caliendo
- Division of Nursing, Carlow University, Pittsburgh, PA 15213, USA.
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38
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Abstract
Recurrent omphalitis is seen more frequently in children, but clinicians world-wide are occasionally challenged by cases of recurrent omphalitis in adults. Apart from folliculitis and infections associated with pilonidal cysts and piercing of the umbilical area, the clinician should consider the possibility of infected remnants of the allantois or the omphalomesenteric (vitelline) duct in adult patients with recurrent omphalitis. Imaging tests such as ultrasound and computed tomography scan frequently help to identify the exact cause of recurrent omphalitis. The combined surgical and medical management usually leads to cure of the problem.
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Affiliation(s)
- S K Kasiakou
- Department of Medicine, Henry Dunant Hospital, Athens, Greece
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39
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Demirtas Y, Sariguney Y, Cukurluoglu O, Ayhan S, Celebi C. Nipple Piercing: It Is Wiser to Avoid in Patients with Hyperprolactinemia. Dermatol Surg 2004; 30:1184. [PMID: 15274719 DOI: 10.1111/j.1524-4725.2004.30354.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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40
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Nipple Piercing. Dermatol Surg 2004. [DOI: 10.1097/00042728-200408000-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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41
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42
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Zardawi IM, Jones F, Clark DA, Holland J. Gordonia terrae-induced suppurative granulomatous mastitis following nipple piercing. Pathology 2004; 36:275-8. [PMID: 15203738 DOI: 10.1080/00313020410001692639] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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43
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Abstract
Until recently body piercing was mainly confined to the ears and/or nose. In the last few years there has been a significant increase in the prevalence of body piercing which, in some instances, has had serious health consequences. This industry has the potential to significantly damage or interfere with health care. Urgent legislation is needed to remedy this situation.
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Affiliation(s)
- Umo I Esen
- Department of Obstetrics and Gynaecology, South Tyneside Healthcare Trust, South Shields, Tyne and Wear NE34 0PL
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44
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Fox LP, Geyer AS, Husain S, Della-Latta P, Grossman ME. Mycobacterium abscessus cellulitis and multifocal abscesses of the breasts in a transsexual from illicit intramammary injections of silicone. J Am Acad Dermatol 2004; 50:450-4. [PMID: 14988690 DOI: 10.1016/j.jaad.2003.09.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We report the case of a 29-year-old transsexual who developed Mycobacterium abscessus infection after receiving intramammary liquid silicone injections in the nonphysician office setting. Our patient represents 1 of 14 confirmed and 11 suspected cases in New York City of M abscessus infection after illicit cosmetic procedures. As injectable cosmetic procedures are becoming increasingly popular, dermatologists should be aware of both the common and unusual complications. Furthermore, all physicians should be alerted to the current cluster of M abscessus infections after injections for cosmetic purposes by nonmedical practitioners in New York City.
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Affiliation(s)
- Lindy Peta Fox
- Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York City, NY, USA
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45
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Adékambi T, Colson P, Drancourt M. rpoB-based identification of nonpigmented and late-pigmenting rapidly growing mycobacteria. J Clin Microbiol 2003; 41:5699-708. [PMID: 14662964 PMCID: PMC308974 DOI: 10.1128/jcm.41.12.5699-5708.2003] [Citation(s) in RCA: 394] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2003] [Revised: 06/19/2003] [Accepted: 07/25/2003] [Indexed: 02/04/2023] Open
Abstract
Nonpigmented and late-pigmenting rapidly growing mycobacteria (RGM) are increasingly isolated in clinical microbiology laboratories. Their accurate identification remains problematic because classification is labor intensive work and because new taxa are not often incorporated into classification databases. Also, 16S rRNA gene sequence analysis underestimates RGM diversity and does not distinguish between all taxa. We determined the complete nucleotide sequence of the rpoB gene, which encodes the bacterial beta subunit of the RNA polymerase, for 20 RGM type strains. After using in-house software which analyzes and graphically represents variability stretches of 60 bp along the nucleotide sequence, our analysis focused on a 723-bp variable region exhibiting 83.9 to 97% interspecies similarity and 0 to 1.7% intraspecific divergence. Primer pair Myco-F-Myco-R was designed as a tool for both PCR amplification and sequencing of this region for molecular identification of RGM. This tool was used for identification of 63 RGM clinical isolates previously identified at the species level on the basis of phenotypic characteristics and by 16S rRNA gene sequence analysis. Of 63 clinical isolates, 59 (94%) exhibited <2% partial rpoB gene sequence divergence from 1 of 20 species under study and were regarded as correctly identified at the species level. Mycobacterium abscessus and Mycobacterium mucogenicum isolates were clearly distinguished from Mycobacterium chelonae; Mycobacterium mageritense isolates were clearly distinguished from "Mycobacterium houstonense." Four isolates were not identified at the species level because they exhibited >3% partial rpoB gene sequence divergence from the corresponding type strain; they belonged to three taxa related to M. mucogenicum, Mycobacterium smegmatis, and Mycobacterium porcinum. For M. abscessus and M. mucogenicum, this partial sequence yielded a high genetic heterogeneity within the clinical isolates. We conclude that molecular identification by analysis of the 723-bp rpoB sequence is a rapid and accurate tool for identification of RGM.
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Affiliation(s)
- Toïdi Adékambi
- Unité des Rickettsies, CNRS UMR 6020 IFR 48, Faculté de Médecine, Université de la Méditerranée, Marseille, France
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46
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Abstract
Body piercing is increasing in popularity around the world. In this review, I describe the history, origins, and peculiarities of various forms of body piercing, and procedures involved, variations in healing time, legal aspects and regulations, and complications and side-effects. I have also included a discussion of the motivation for and psychological background behind body piercing. In presenting research results, I aim to raise awareness of the many risks associated with body piercing. In presenting psychological data, I intend to create an understanding of the multifaceted and often intense motivations associated with body piercing, and, thus, to diminish any prejudices held by health professionals against people with piercings.
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Affiliation(s)
- Aglaja Stirn
- Klinikum der Johann-Wolfgang-Goethe-Universitaet, Klinik fuer Psychosomatische Medizin und Psychotherapie, Psychotherapeutische Ambulanz (Hs 93), D-60528 am Main, Frankfurt, Germany.
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48
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Novedades en Dermatología quirúrgica. ACTAS DERMO-SIFILIOGRAFICAS 2002. [DOI: 10.1016/s0001-7310(02)76559-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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