All in The Name of Vanity: An Unanticipated Outcome of Mycobacterium abscessus Infection

We report a case of refractory skin abscesses caused by Mycobacterium abscessus resulting from cosmetic surgery. A 25-year-old woman developed recurrent cutaneous infection caused by M. abscessus after multiple cosmetic surgeries in the Dominican Republic. Despite of the removal of infected implants, she failed a 20-month treatment with azithromycin, cefoxitin, and amikacin. The patient presented to our institution 28 months after the initial surgeries and approximately 5 months after initiation of her latest antimicrobial regimen of azithromycin, imipenem, and amikacin. Here, she was restarted on cefoxitin 2 g daily, amikacin 750 mg daily, and azithromycin 1000 mg daily. She completed an additional 4 months (a total of 9 months) of therapy with complete clinical resolution. In conclusion, clinical suspicion of M. abscessus infection is essential for the diagnosis. Patient compliance is integral to a successful outcome because the treatment involves prolonged duration, continuous intravenous antibiotics, and multiple potential adverse effects. Correspondence to: George M. Abraham, MD, MPH, FACP, FIDSA, Department of Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA. E-mail: george.abraham@stvincenthospital.com. The authors have no funding or conflicts of interest to disclose. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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