BACKGROUND In recent years,the cosmetic intervention related infections caused by nontuberculous mycobacteria(NTM)are increasing as the informal cosmetic treatments are performed.However,many dermatologists are inexpe...BACKGROUND In recent years,the cosmetic intervention related infections caused by nontuberculous mycobacteria(NTM)are increasing as the informal cosmetic treatments are performed.However,many dermatologists are inexperienced in the diagnosis and management of similar cases.Here we report a case of subcutaneous infection caused by Mycobacterium abscessus(M.abscessus)following cosmetic injections of botulinum toxin.CASE SUMMARY A 53-year-old woman presented with multiple abscesses and nodules on her forehead and both temporal sites for half a month after cosmetic injections of botulinum toxin.Her lesions did not show any alleviation after 2-wk prescription of antibiotics.Laboratory examinations indicated that she had no sign of immunodeficiency and the whole body of computed tomography did not find any systemic infection or diseases.The pathology of skin tissue showed inflammatory cell infiltration with the negative results of Periodic acid Schiff(PAS)and Acidfast staining and the culture yielded no microbiome.Afterwards,the puncture on abscess was performed and M.abscessus was successfully isolated.The pathogen was identified by acid-fast staining and DNA sequencing.The patient was treated with the strategy of clarithromycin,ofloxacin,and amikacin according to the result of drug sensitivity test and got complete remission of the lesions.CONCLUSION The case presents the whole process of diagnosis and management of NTM infection after cosmetic intervention and highlights the diagnostic thoughts.In a word,the mycobacterium infection should be aware in patients after cosmetic performance.展开更多
Background: Infectious keratitis after refractive surgery is uncommon, and mycobacterium abscess has never been observed in corneal infections in China. Purpose: To propose an unusual presentation of two cases about M...Background: Infectious keratitis after refractive surgery is uncommon, and mycobacterium abscess has never been observed in corneal infections in China. Purpose: To propose an unusual presentation of two cases about Mycobacterium abscess infection after laser in situ keratomileusis (LASIK). Participants: Both cases 1 and 2 were females who exhibited a corneal ulceration after LASIK in the same hospital. Methods: The first patient in the study was a 28-year-old woman who underwent Epi-LASIK surgery in both eyes. She developed an infectious corneal ulcer in one eye after 50 days post-surgery. She was referred to our out-patient clinic 3 months post-surgery with corneal perforation, and was treated with a therapeutic penetrating keratoplasty. The second patient was a 27-year-old woman who developed infectious keratitis in one eye after 2 months after bilateral LASIK and was referred to us 3 months later. Results: Cultures in both the cases were identified as a Mycobacterium abscess, and case 1 was treated with penetrating keratoplasty eventually, while case 2 recovered after sensitive treatment. Conclusions: Infectious keratitis after refractive surgery is uncommon, and Mycobacterium abscess has never been observed in corneal infections. An accurate diagnosis and identification of the causative agent is very important.展开更多
The hepatic tuberculosis is rare. The interest of this Knowledge consists in the diagnostic problems particularly in its primitive and macronodular forms. It touches all ages with a peak of frequency during 17 - 50 ye...The hepatic tuberculosis is rare. The interest of this Knowledge consists in the diagnostic problems particularly in its primitive and macronodular forms. It touches all ages with a peak of frequency during 17 - 50 years old, and a female prevalence. The clinical picture is polymorphous but it is still dominated by the prolonged fever and the alteration of the general state. Case report: 30-year-old female was admitted to our hospital with painless swelling on the right side of chest and feeling of pressure in the right upper quadrant of abdomen. She has no history of fever, weight loss, and night sweating or poor appetite. On clinical examination, the patient was in good general condition. The inflammatory tumefaction of the right chest wall was marked. The palpation of the abdomen revealed a sensitive hepatomegaly. A CT scan revealed a large cystic liver. The laboratory investigations were normal. This appearance was suggestive of a hydatid cyst of the right liver and a surgical management was decided. But the histological study revealed granulomatous inflammation consisting of tuberculoid type granuloma with caseous necrosis. However, abscess of the liver due to MT was highly suspected and anti-tuberculosis therapy was started, the patient responded well. Conclusion: The analysis of this observation and the data of the literature make it possible to retain the rarity;the polymorph expression and not very suggestive of this location.展开更多
文摘BACKGROUND In recent years,the cosmetic intervention related infections caused by nontuberculous mycobacteria(NTM)are increasing as the informal cosmetic treatments are performed.However,many dermatologists are inexperienced in the diagnosis and management of similar cases.Here we report a case of subcutaneous infection caused by Mycobacterium abscessus(M.abscessus)following cosmetic injections of botulinum toxin.CASE SUMMARY A 53-year-old woman presented with multiple abscesses and nodules on her forehead and both temporal sites for half a month after cosmetic injections of botulinum toxin.Her lesions did not show any alleviation after 2-wk prescription of antibiotics.Laboratory examinations indicated that she had no sign of immunodeficiency and the whole body of computed tomography did not find any systemic infection or diseases.The pathology of skin tissue showed inflammatory cell infiltration with the negative results of Periodic acid Schiff(PAS)and Acidfast staining and the culture yielded no microbiome.Afterwards,the puncture on abscess was performed and M.abscessus was successfully isolated.The pathogen was identified by acid-fast staining and DNA sequencing.The patient was treated with the strategy of clarithromycin,ofloxacin,and amikacin according to the result of drug sensitivity test and got complete remission of the lesions.CONCLUSION The case presents the whole process of diagnosis and management of NTM infection after cosmetic intervention and highlights the diagnostic thoughts.In a word,the mycobacterium infection should be aware in patients after cosmetic performance.
文摘Background: Infectious keratitis after refractive surgery is uncommon, and mycobacterium abscess has never been observed in corneal infections in China. Purpose: To propose an unusual presentation of two cases about Mycobacterium abscess infection after laser in situ keratomileusis (LASIK). Participants: Both cases 1 and 2 were females who exhibited a corneal ulceration after LASIK in the same hospital. Methods: The first patient in the study was a 28-year-old woman who underwent Epi-LASIK surgery in both eyes. She developed an infectious corneal ulcer in one eye after 50 days post-surgery. She was referred to our out-patient clinic 3 months post-surgery with corneal perforation, and was treated with a therapeutic penetrating keratoplasty. The second patient was a 27-year-old woman who developed infectious keratitis in one eye after 2 months after bilateral LASIK and was referred to us 3 months later. Results: Cultures in both the cases were identified as a Mycobacterium abscess, and case 1 was treated with penetrating keratoplasty eventually, while case 2 recovered after sensitive treatment. Conclusions: Infectious keratitis after refractive surgery is uncommon, and Mycobacterium abscess has never been observed in corneal infections. An accurate diagnosis and identification of the causative agent is very important.
文摘The hepatic tuberculosis is rare. The interest of this Knowledge consists in the diagnostic problems particularly in its primitive and macronodular forms. It touches all ages with a peak of frequency during 17 - 50 years old, and a female prevalence. The clinical picture is polymorphous but it is still dominated by the prolonged fever and the alteration of the general state. Case report: 30-year-old female was admitted to our hospital with painless swelling on the right side of chest and feeling of pressure in the right upper quadrant of abdomen. She has no history of fever, weight loss, and night sweating or poor appetite. On clinical examination, the patient was in good general condition. The inflammatory tumefaction of the right chest wall was marked. The palpation of the abdomen revealed a sensitive hepatomegaly. A CT scan revealed a large cystic liver. The laboratory investigations were normal. This appearance was suggestive of a hydatid cyst of the right liver and a surgical management was decided. But the histological study revealed granulomatous inflammation consisting of tuberculoid type granuloma with caseous necrosis. However, abscess of the liver due to MT was highly suspected and anti-tuberculosis therapy was started, the patient responded well. Conclusion: The analysis of this observation and the data of the literature make it possible to retain the rarity;the polymorph expression and not very suggestive of this location.