Localized Mycobacterium avium-intracellulare mastitis in an immunocompetent woman with silicone breast implants

While M. avium-intracellulare has received increasing recognition due to its association with AIDS, silicone breast implants have come under increased FDA scrutiny, requiring new safety and efficacy protocols. We report a case of localized M. avium-intracellulare mastitis associated with a breast implant in an immunocompetent, HIV-negative woman who was cured with implant removal and a long course (6 months) of clarithromycin. Serous exudates occurring in association with breast implants should be cultured for acid-fast organisms. Clarithromycin may be a therapeutic adjunct to effectively cure these infections.