Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2022; 10(18): 6141-6147
Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6141
Subcutaneous infection caused by Mycobacterium abscessus following cosmetic injections of botulinum toxin: A case report
Lin Deng, Ying-Zhi Luo, Fang Liu, Xiao-Hong Yu
Lin Deng, Ying-Zhi Luo, Xiao-Hong Yu, Department of Dermatology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Fang Liu, Department of Dermatology, Jinling Hospital, Nanjing 210002, Jiangsu Province, China
Author contributions: Yu XH and Deng L were the patient’ dermatologists; Deng L collected the data; Luo YZ and Liu F contributed to manuscript drafting and literature review.
Informed consent statement: Informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu XH, MD, Doctor, Professor, Department of Dermatology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, No. 261 Huansha Street, Hangzhou 310006, Zhejiang Province, China. 1191656901@qq.com
Received: October 26, 2021
Peer-review started: October 26, 2021
First decision: December 17, 2021
Revised: December 27, 2021
Accepted: April 28, 2022
Article in press: April 28, 2022
Published online: June 26, 2022
Abstract
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 Acid-fast 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.

Keywords: Mycobacterium abscesses, Skin infection, Cosmetic injection, Nontuberculous mycobacteria, Case report

Core Tip: The article reports a case of subcutaneous infection caused by Mycobacterium abscessus after cosmetic intervention. We present the medical history and whole process of diagnosis and management of the case and made a literature review of similar infections. The paper is trying to provide some more experience for dermatologists.