Invasive Zygomycete Infection of Silicone Augmentation Mammoplasty In An Immunocompetent Patient. | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Articles in Press, Accepted Manuscript, Available Online from 11 September 2024 | ||
| Document Type: Case Report | ||
| DOI: 10.21608/ejprs.2024.284446.1370 | ||
| Authors | ||
| Rania Zein eldin* 1; Manik Menezes2; Mohammed Khan3; Supryia Sundaram4 | ||
| 1RESPIRATORY SPECIALIST Burjeel hospital Abudhabi | ||
| 2Mch plastic surgery Burjeel hospital Abudhabi | ||
| 3Head of department for Inpatient department Burjeel hospital Abudhabi | ||
| 4MD CCT FRCP Consultant pulmonologist Burjeel hospital Abudhabi | ||
| Abstract | ||
| Introduction Invasive Zygomycete infection of skin and subcutaneous tissue is rare but can be life threatening. It is seen more commonly in immunosuppressed patients such as those with diabetes or malignancy. It is now increasingly being reported in immunocompetent patients. The infection may be acquired directly through inoculation after direct trauma or could be iatrogenic.The disease causes extensive necrosis and is angio-invasive. Case report A previously healthy 44-year-old lady was admitted with five days post aesthetic surgery for bilateral breast implants. She had severe pain and erythema at the wound site of implant in the right breast. The infection then spread to the left breast site as well. When intravenous antibiotics failed to resolve the infection, surgical removal of implant was carried out initially of the right then the left breast. Zygomycete species was identified in the necrotic tissue. Extensive necrotic tissue was found and the patient needed repeated episodes of wound debridement. The patient was commenced on amphotericin B but suffered side effects. Oral Posaconazole was well tolerated and resulted in complete healing. The patient remained hospitalised for eight weeks. Oral antifungal treatment was given for a total of six months until all inflammatory parameters returned to normal and the wound site in each breast was ready for skin grafting. Conclusion Post surgical inflammation in the breast not responding to regular intravenous antibiotic treatment needs special and urgent care. Fungal infection must be suspected in immunocompetent as well as immunocompromised patients. Successful treatment is possible if an early and timely diagnosis is made. Adequate surgical debridement and prolonged course of oral systematic anti-fungal treatment is key to management. | ||
| Keywords | ||
| Zygomycete; mucormycosis infection; complication of breast implant surgery | ||
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