ABSTRACT
Skin necrosis is one of the most severe complications following filler injections, and can result in permanent aesthetic defects. Although an increasing number of studies have addressed the management of dermal filler complications, no study has described the spectrum of microbial pathogens. The aim of this study was to delineate the bacterial profile and prognostic factors of filler-related skin necrosis by reviewing the clinical and microbiological features of these patients. A retrospective medical record review of patients undergoing treatment for skin necrosis induced by fillers was conducted. In total, 10 cases were identified, with injection sites being the nasolabial fold (70%; n = 7), nasal dorsum (20%; n = 2) and nasal tip (10%; n = 1). Reviewing the culture results, the true culture-positive rate was found to be 50% after cases of contamination were excluded. To avoid permanent sequelae, all physicians should be aware of possible secondary infections when treating filler-induced skin necrosis.
Subject(s)
Dermal Fillers/adverse effects , Necrosis/chemically induced , Necrosis/microbiology , Skin Diseases/etiology , Adult , Anti-Bacterial Agents/standards , Anti-Bacterial Agents/therapeutic use , Culture Techniques/methods , Culture Techniques/statistics & numerical data , Dermal Fillers/administration & dosage , Female , Gram-Negative Bacteria/growth & development , Gram-Negative Bacteria/isolation & purification , Humans , Injection Site Reaction/microbiology , Injection Site Reaction/pathology , Middle Aged , Nasolabial Fold/microbiology , Nasolabial Fold/pathology , Necrosis/diagnosis , Necrosis/therapy , Nose/microbiology , Nose/pathology , Prognosis , Re-Epithelialization/physiology , Retrospective Studies , Severity of Illness Index , Skin Diseases/pathologyABSTRACT
A 71-year-old woman with metastatic squamous cell carcinoma of the lung and insulin-dependent type 2 diabetes mellitus presented with a necrotic lesion on her lower abdomen. Further history revealed that this was the site of repeat insulin injections with reuse of the same needles. On investigation, biopsy of the site was positive for broad, aseptate, right-angle branching fungal hyphae consistent with mucormycosis. Studies have shown that insulin needle reuse is a common practice among diabetics for several reasons, including cost and convenience. While the current American Diabetes Association guidelines suggest that this is an acceptable practice among the general population of diabetics, they advise against it in patients who are actively ill or immunocompromised. Discussion about insulin needle reuse should be of utmost importance among providers and their diabetic patients, especially for patients who are immunocompromised.
Subject(s)
Abdomen/pathology , Dermatomycoses/therapy , Injection Site Reaction/microbiology , Injections, Subcutaneous/adverse effects , Mucormycosis/etiology , Mucormycosis/therapy , Aged , Anti-Bacterial Agents/therapeutic use , Antifungal Agents/therapeutic use , Dermatomycoses/microbiology , Diabetes Mellitus, Type 2/drug therapy , Female , Humans , Immunocompromised Host , Insulin/adverse effects , Lung Neoplasms/complications , Necrosis , Nitriles/therapeutic use , Pyridines/therapeutic use , Triazoles/therapeutic use , Vancomycin/therapeutic useABSTRACT
BACKGROUND: The incidence of Mycobacterium abscessus infections has increased in recent years. Some of these infections are caused by invasive cosmetic procedures. AIMS: Raising the awareness of cosmetic procedure related Mycobacterium abscessus infection for clinicians. PATIENTS/METHODS: We presented a 28-year-old woman who developed multiple erythema and painful nodules in her lower extremities after injections of botulinum toxin. RESULTS: Mycobacterium culture and strain identification of the tissue confirmed Mycobacterium abscessus. Combination antibiotics therapy was given and the lesion healed with scar and pigmentation. CONCLUSION: Mycobacterium abscessus infections following injection of botulinum toxin are rare and easily misdiagnosed as common suppurative infections. Early microbiologic tests are necessary for diagnose. Standardized operation should be performed to avoid this particular infection.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Botulinum Toxins/adverse effects , Cosmetic Techniques/adverse effects , Injection Site Reaction/diagnosis , Mycobacterium Infections, Nontuberculous/diagnosis , Adult , Biopsy , Botulinum Toxins/administration & dosage , Drug Therapy, Combination , Female , Humans , Injection Site Reaction/drug therapy , Injection Site Reaction/microbiology , Injection Site Reaction/pathology , Lower Extremity , Mycobacterium Infections, Nontuberculous/drug therapy , Mycobacterium Infections, Nontuberculous/etiology , Mycobacterium Infections, Nontuberculous/pathology , Mycobacterium abscessus/isolation & purification , Skin/microbiology , Skin/pathologySubject(s)
Dermal Fillers/adverse effects , Injection Site Reaction/diagnosis , Staphylococcal Skin Infections/diagnosis , Staphylococcus lugdunensis/isolation & purification , Anti-Bacterial Agents/administration & dosage , Cheek , Dermal Fillers/administration & dosage , Drainage , Female , Humans , Hydrogels/administration & dosage , Hydrogels/adverse effects , Injection Site Reaction/microbiology , Injection Site Reaction/therapy , Middle Aged , Staphylococcal Skin Infections/microbiology , Staphylococcal Skin Infections/therapy , Time Factors , Treatment OutcomeSubject(s)
Hand/pathology , Infections/pathology , Injection Site Reaction/pathology , Pain/pathology , Prototheca/isolation & purification , Steroids/adverse effects , Female , Hand/microbiology , Humans , Infections/therapy , Injection Site Reaction/microbiology , Injection Site Reaction/therapy , Injections, Intramuscular/adverse effects , Middle Aged , Pain/microbiology , Steroids/administration & dosageABSTRACT
Weight loss clinics are common in the United States. Unfortunately, some offer dubious weight loss methods such as self-administered human chorionic gonadotropic (HCG) injections. HCG products are unregulated, yet, widely available. Infection is among the risks potentially associated with this treatment. We report a case of skin infection caused by Mycobacterium fortuitum after HCG injection.