Necrotizing Fasciitis Due to Acinetobacter baumannii Complex Following Body Contouring Surgery: First Case Report.

Area of Science:

• Infectious Diseases
• Plastic Surgery
• Microbiology

Background:

• Aesthetic surgery, including liposuction and fat transfer, is increasingly common worldwide.
• Postoperative infections are a known risk, with multidrug-resistant Gram-negative bacilli posing a serious threat.
• Necrotizing soft tissue infections (NSTIs) are severe complications that can be life-threatening.

Observation:

• A 40-year-old woman developed septic shock from deep necrotizing fasciitis in her thigh and buttock post-liposuction and fat transfer.
• Tissue cultures identified multidrug-resistant Acinetobacter baumannii complex haemolyticus, a nonfermenting Gram-negative bacillus.
• This pathogen is typically associated with nosocomial infections, not NSTIs following aesthetic surgery.

Findings:

• The patient required surgical debridement, fasciotomy, and combination antibiotic therapy.
• Acinetobacter baumannii was sensitive to carbapenems, and the patient recovered after a 14-day antibiotic course.
• This is the first reported case of NSTI caused by Acinetobacter baumannii after aesthetic body contouring surgery.

Implications:

• Highlights the potential for Acinetobacter baumannii to cause severe soft tissue infections in the context of aesthetic procedures.
• Underscores the importance of considering unusual pathogens in postoperative infections, even those typically caused by Gram-positive bacteria or fermenting Gram-negatives.
• Suggests that the persistence of Acinetobacter baumannii on inanimate surfaces may be underestimated in healthcare settings related to cosmetic surgery.