title: Mycobacterium fortuitum and anaerobic breast abscess following nipple piercing: case presentation and review of the literature.
abstract: OBJECTIVE
  Body piercing has become increasingly prevalent. We describe a case of breast infection with combined mycobacteria and anaerobe following nipple piercing, and review the literature.
  
  
  METHODS
  A 17-year-old female developed a breast abscess 4 months after nipple piercing. Cultures grew Prevotalla melangenica and Mycobacterium fortuitum. She required drainage and antibiotic treatment. Three months into her treatment she stopped her medications, relapsed, and required drainage. Two months later, on antimycobacteria therapy, her wound is healing.
  
  
  CONCLUSIONS
  Review of the infectious complications of nipple piercing yielded 12 cases, 5 of which had a foreign body. The pathogens isolated (coagulase negative staphylococcus, mycobacteria, streptococcus, anaerobe, and gordonia) are not the usual organisms to be isolated from a breast abscess. This could result from reporting bias or the presence of a foreign body, the nipple ring. The three cases of mycobacteria, in addition to ours, are reviewed. The average age is 22 years. Three to 9 months elapsed between piercing and infection. All cases required drainage. Antimycobacteria therapy was used in three of the four cases for 10 days to 6 months.
  
  
  CONCLUSIONS
  With the increasing prevalence of body piercing, it is important to document and report infections. We describe a breast abscess following nipple piercing with combined anaerobic and a mycobacterial pathogens. This underscores the need for obtaining cultures including anaerobes and mycobacteria.
authors.affiliation: St. Barnabas Hospital, Department of Infectious Diseases, Bronx, New York 10457, USA. vbengualid@pol.net
authors.forename: Victoria
authors.initials: V
authors.lastname: Bengualid
authors.forename: Veera
authors.initials: V
authors.lastname: Singh
authors.forename: Herpreet
authors.initials: H
authors.lastname: Singh
authors.forename: Judith
authors.initials: J
authors.lastname: Berger
mesh_terms: D000038:Abscess / Q000382:microbiology* / Q000628:therapy; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016866:Bacteroidaceae Infections / Q000209:etiology / Q000382:microbiology / Q000628:therapy; D046288:Body Piercing / Q000009:adverse effects*; D001941:Breast Diseases / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D004322:Drainage; D005260:Female; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D019907:Mycobacterium fortuitum / Q000302:isolation & purification*; D001443:Prevotella melaninogenica / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents