[Soft-tissue infections due to non-tuberculous mycobacteria following mesotherapy. What is the price of beauty].
BACKGROUND
Mesotherapy is widely used In Latin America for cosmetic purposes, particularly in obese individuals. We describe the clinical and epidemiological characteristics, microbiological diagnosis, treatment and follow-up of patients from Caracas (Venezuela) with soft tissue infection caused by non-tuberculous mycobacteria following mesotherapy.


METHODS
Between March 2002 and December 2003, we evaluated 49 cases of skin and soft tissue infection following mesotherapy. Specimens obtained from the lesions and 15 products used in the mesotherapy procedure were cultured for the presence of non-tuberculous mycobacteria. Isolated mycobacteria were identified by PCR restriction fragment length polymorphism analysis of the hsp65 gene.


RESULTS
Infection by non-tuberculous mycobacteria was confirmed in 81.6% of the 49 cases. Mycobacterium abscessus and M. fortuitum were the most common species, but M. chelonae, M. peregrinum, M. simiae and a new species that was designated "M. cosmeticum" were also isolated. Patients were treated with species-specific antibiotic agents for 3 to 18 months. Investigation into the source of the infection revealed that 21 patients were clustered within 3 different outbreaks and two products were found to be contaminated with M. fortuitum and M. abscessus, respectively.


CONCLUSIONS
Physicians should be alerted to the possibility of infection by non-tuberculous mycobacteria in patients with a history of mesotherapy who develop late-onset skin and soft tissue infection, particularly if they do not respond to conventional antibiotic treatment.
Rivera-Olivero
Ismar Alejandra
IA
Laboratorio de Tuberculosis, Instituto de Biomedicina, Caracas, Venezuela.
Guevara
Armando
A
Escalona
Arnelly
A
Oliver
Margarita
M
Pérez-Alfonzo
Ricardo
R
Piquero
Jaime
J
Zerpa
Olga
O
de Waard
Jacobus H
JH
D000038:Abscess / Q000209:etiology / Q000382:microbiology; D000328:Adult; D003357:Cosmetic Techniques / Q000009:adverse effects* / Q000592:standards; D004196:Disease Outbreaks; D004340:Drug Contamination; D005148:Facial Dermatoses / Q000209:etiology / Q000382:microbiology; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous / Q000009:adverse effects*; D008004:Licensure; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D016926:Mycobacterium chelonae / Q000302:isolation & purification; D019907:Mycobacterium fortuitum / Q000302:isolation & purification; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000302:isolation & purification*; D018461:Soft Tissue Infections / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D012996:Solutions / Q000009:adverse effects*; D013045:Species Specificity; D014382:Tuberculosis, Cutaneous / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D014687:Venezuela / Q000453:epidemiology
D012996:Solutions