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allied
academies
September 20-21, 2017 | Philadelphia, USA
Global summit on
TUBERCULOSIS AND LUNG DISEASE
Int J Respir Med 2017 Volume 2 Issue 2
Mycobacterium fortuitum
as a rare etiology of red breast syndrome: A case report and review of
literature
Benjamin O Lawson
and
Laura Schroeder
Honor Health Medical Center, USA
Background:
Based on the 2015 plastic surgery statistics
report, 106,338 females underwent breast reconstructive
surgery in the United States. Infection following breast
reconstruction with tissue expanders and implants remains
a concern, with a reported incidence that ranges from 1 to
6 percent. We present a case of patient who developed red
breast syndrome after undergoing breast reconstructive
surgery involving a tissue expander placement without an
acellular dermal matrix product.
Case Presentation:
A 54-year-old otherwise healthy female
underwent a left modified radical mastectomy and right
prophylactic simple mastectomy for inflammatory breast
cancer. Pathology returned as Grade III invasive ductal
carcinoma with 1/7 positive lymph nodes in left breast
and lobular carcinoma
in situ
in right breast. Five years
later, she underwent bilateral breast reconstruction with
tissue expanders. Two and a half months later, the patient
noticed a small area of redness. She was diagnosed with
mastitis and IV vancomycin and ceftriaxone were initiated.
The patient returned to the operating room two days later
where an exchange of right breast tissue expander with
another expander and debridement within the breast
pocket with lateral and inferior pole capsulotomies was
performed. During that procedure, cultures were taken
and subsequently grew
M. fortuitum
. She was discharged
home with IV amikacin and cefoxitin through PICC line, and
changed to oral ciprofloxacin and clarithromycin based on
sensitivities. Her infection cleared shortly thereafter.
Discussion:
M. fortuitum
is classified as nontuberculous
Mycobacterium
that is described as rapidly growing
mycobacteria as they usually grow in subculture within
one week.
M. fortuitum
is considered the most common
rapidly growing
Mycobacterium
(RGM) from non-respiratory
specimens (11). If there is high suspicion for nontuberculous
mycobacterial infection, then it is recommended empiric
therapy to include intravenous amikacin plus intravenous
Cefoxitin and total treatment for a minimum of 3-6 months.
To our knowledge and after literature search, this is the
first report of
M. fortuitum
cultured status post breast
reconstructive surgery with tissue expanders, not implants
and without acellular dermal matrix.
Speaker Biography
Benjamin O Lawson has attended medical school at the Universidad Autónoma
de Guadalajara in Guadalajara, Mexico where he has graduated valedictorian of
his class in 2015. He completed undergraduate studies at the University of Arizona
with a Bachelor of Science degree in Ecology and Evolutionary Biology with a minor
in Business Administration. From 2015-2016, he completed an internship year in
General Surgery at Banner University Medical Center in Phoenix, AZ. He is currently,
practicing medicine as an Internal Medicine Resident at Honor Health Medical Center
in Scottsdale, AZ. His research interests are in quality improvement, rare infections,
and Eosinophilic Esophagitis.
e:
benlawson32@yahoo.com