Periprosthetic atypical mycobacterial infection in breast implants: a new kid on the block!

Breast augmentation is one of the most commonly performed cosmetic surgical procedures. Infection in the breast implant surgery can range from simple wound infection to periprosthetic infection usually with skin commensals such as staphylococci. However, with routine use of broad-spectrum antibiotics atypical mycobacterial infections are being increasingly reported.

We studied 12 cases of atypical mycobacterial breast implant infections over a period of 8 years from 2002 to 2010. Six of them were primarily operated at our centre and six referred from elsewhere after implant infection. Age range was 30-40 years and follow-up after secondary surgery ranged from 1 to 5 years. All patients were explanted and started on combination antibiotics namely, clarithromycin, gatifloxacillin and linezolid for 3 months. After a period of 3 months, all patients underwent implant surgery again with the same antibiotic cover for 6 weeks.

All the secondary implant augmentations were successful. Organisms grown in primary culture were Mycobacterium fortuitum and M. chelonei. All patients were satisfied with the final breast form and size achieved.

The possibility of an atypical mycobacterial infection should always be at the back of the mind of an alert surgeon to prevent a periprosthetic infection from compromising the final aesthetic result of a breast implant procedure. Diagnosed early and eradicated in time, the final result is not compromised.