title: Mixed infection of an atypical Mycobacterium and Aspergillus following a cryopreserved fat graft to a face.
abstract: We report a chronic infection of a patient who received a cryopreserved fat graft on her face. A 22-year-old female patient presented with multiple abscesses of her face. Four months previously, she received a second fat graft with the fat harvested at a previous surgery which was cryopreserved for 2 months. On examination, she had tender erythematous nodules on both cheeks. A computed tomography of her neck showed multiple peripheral enhancing nodular lesions. In an open pus fungus culture, Aspergillus fumigatus growth was observed. On the Mycobacterium Other Than Tuberculosis identification PCR, Mycobacterium fortuitum was found. She was treated with levofloxacin, clarithromycin, and minocycline for 11 months, and finally the symptoms subsided. To avoid infection after the fat graft, cryopreserved fat should not be used as a possible grafting material. In cases of persistent infection, or in cases of waxes and gains after drainage of pus and short-term antibiotics therapy, atypical Mycobacterium or Aspergillus should be suspected and a PCR for them should be carried out.
authors.affiliation: Fom the *Department of Plastic Surgery, Inha University School of Medicine, Incheon; †Dr Kim's Aesthetic Surgical Plastic Clinic, Seoul; and ‡Center for Advanced Medical Education by the BK21 Project, Inha University School of Medicine, Incheon, Korea.
authors.forename: Seong Kee
authors.initials: SK
authors.lastname: Kim
authors.forename: Han Joon
authors.initials: HJ
authors.lastname: Kim
authors.forename: Kun
authors.initials: K
authors.lastname: Hwang
mesh_terms: D000038:Abscess / Q000601:surgery; D000273:Adipose Tissue / Q000637:transplantation*; D001228:Aspergillosis / Q000209:etiology*; D001230:Aspergillus / Q000302:isolation & purification; D002908:Chronic Disease; D060085:Coinfection / Q000382:microbiology; D015925:Cryopreservation; D005145:Face / Q000601:surgery*; D005260:Female; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000209:etiology*; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification; D011183:Postoperative Complications; D014021:Tissue Preservation; D014182:Transplantation, Autologous / Q000009:adverse effects*; D055815:Young Adult