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Published on: December 3, 2017
Necrotizing fasciitis after breast augmentation: rapid microbiologic detection by using sonication of removed
Erlangga Yusuf1, Julia Steinrücken2, Sophie Nordback3
1From the Infectious Diseases Service, Department of Medicine angga.yusuf@gmail.com.
Objectives:
To describe the use of sonication and microcalorimetry in diagnosing necrotizing fasciitis in a 27-year-old woman with bilateral breast implants.
Methods:
The removed breast implants were subjected to sonication and microcalorimetry. The microcalorimetry findings were correlated with conventional microbiologic methods. The time to detection of infection was noted.
Results:
The patient had painful cellulitis of the right breast that enlarged within hours. Her C-reactive protein level was increased. Chest radiograph showed gas formation in the soft tissue lateral of the right breast. Surgery was performed: 300 mL (right breast) and 100 mL (left breast) of serous-purulent fluid were evacuated. Streptococcus pyogenes was cultured from the fluid 1 day after clinical presentation. Infection was diagnosed by microcalorimetry of sonication fluid in 1 hour and 21 minutes. The microcalorimetry curve from the right implant reached the peak earlier than did the left implant.
Conclusion:
Microcalorimetry will have a benefit in conditions in which rapid diagnosis of infection is important.
