Outbreak of persistent cutaneous abscesses due to Mycobacterium chelonae after mesotherapy sessions, Lima, Peru

Abstract

Outbreak of persistent cutaneous abscesses due to Mycobacterium chelonae after mesotherapy sessions, Lima, Peru Surto de abscessos cutâneos persistentes por Mycobacterium chelonae pós-mesoterapia, Lima, Peru ABSTRACT Outbreaks of rapidly growing mycobacteria have been occasionally described. The article reports an outbreak of cutaneous abscesses due to Mycobacterium chelonae following mesotherapy in Lima, Peru. From December 2004 through January 2005, 35 subjects who had participated in mesotherapy training sessions presented with persistent cutaneous abscesses. Thirteen (37%) of these suspected cases consented to underwent clinical examination. Skin punch-biopsies were collected from suspicious lesions and substances injected during mesotherapy were analyzed. Suspected cases were mainly young women and lesions included subcutaneous nodules, abscesses and ulcers. Mycobacterium chelonae was isolated from four patients and from a procaine vial. In conclusion, it is important to consider mesotherapy as a potential source of rapidly growing mycobacteria infections. Although rapidly growing mycobacteria (RGM) are ubiquitous, diseases caused by these atypical bacteria are relatively uncommon. 1 Among RGM, Mycobacterium chelonae is particularly prominent. Clinical diseases caused by this agent include cutaneous infections ranging from localized cellulitis to osteomyelitis. The precise burden of disease caused by this microorganism is unknown and most available information comes from occasional case reports. Cutaneous infections caused by RGM, including M. chelonae, have been associated with penetrating cutaneous trauma. Common procedures related to RGM-related infections included injections, liposuction, acupuncture and, more rarely, catheter insertions. 1

Mesoterapia: uma revisão bibliográfica

“…The most feared and most often reported complication is mycobacterial infection, which requires months of treatment with multiple drugs and generally results in unaesthetic scars. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Apparently, secondary infections described in the aforementioned works can be explained by inadequate asepsis before the procedure or by contamination of the product being used.…”

Diversity, Community Composition, and Dynamics of Nonpigmented and Late-Pigmenting Rapidly Growing Mycobacteria in an Urban Tap Water Production and Distribution System

“…Potentially pathogenic RGM are associated with a wide spectrum of diseases in humans, including pulmonary tract, skin, soft tissue, and disseminated infections (10)(11)(12)(13)(14), mostly in patients with predisposing conditions (e.g., lung diseases, chronic obstructive pulmonary disease, cystic fibrosis, genetic predisposition, or immunosuppressive therapy). Contamination and hypersensitive reactions are often due to environmental exposure (associated with, for example, hot tubs, metalworking fluids, or contaminated dust) (15)(16)(17)(18)(19), and many outbreaks following invasive medical procedures have been reported over the last decade (20)(21)(22)(23)(24)(25). Tap water may be an important source of contamination in urban environments (13,18,(26)(27)(28)(29)(30).…”

An outbreak of Mycobacterium chelonae infections in tattoos

“…Although most pathogenic species of NTM have been incriminated in skin and soft tissue infections, the rapidly growing mycobacteria (RGM)eMycobacterium fortuitum, M abscessus, and M chelonaeeare emerging as important causes of localized cutaneous infections in both sporadic cases and outbreak settings. 2 Infections with NTM have been described in association with Mohs micrographic surgery, 4 cutaneous surgery, 5 punch biopsy, 6 acupuncture, 7,8 mesotherapy, 9,10 injections, [11][12][13] cardiothoracic surgery, 14 breast reconstruction, 15 facial…”