title: Percutaneous breast implant herniation: a rare complication of miliary TB.
abstract: We describe the case of a 46-year-old female patient treated for disseminated tuberculosis (TB) infection involving the lungs, urinary tract and skin. Following initiation of antituberculous therapy, the patient's right breast implant eroded through the overlying skin and was seen to be herniating through the resulting defect. The breast implant was removed under local anaesthetic and histological analysis of the resected tissue demonstrated granuloma formation consistent with periprosthetic TB. Wound healing following implant removal was poor and future breast augmentation surgery was only considered following completion of 12 months anti-TB treatment. This case constitutes the first report in the literature of percutaneous breast implant herniation resulting from periprosthetic infection with TB. A high index of suspicion is required to ensure early detection and timely management of TB and, in cases where periprosthetic pus aspirate is sterile, mycobacterial infection must be actively excluded.
authors.affiliation: Department of Medical Microbiology, Basingstoke and North Hampshire Hospitals, Basingstoke, UK.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Dale
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, Birmingham Heartlands Hospital, Heart of England NHS Hospital Trust, Birmingham, UK.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Dedicoat
authors.affiliation: Department of Histopathology, Birmingham Heartlands Hospital, Heart of England NHS Hospital Trust, Birmingham, UK.
authors.forename: Tausif
authors.initials: T
authors.lastname: Saleem
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, Birmingham Heartlands Hospital, Heart of England NHS Hospital Trust, Birmingham, UK.
authors.forename: Ed
authors.initials: E
authors.lastname: Moran
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D001940:Breast; D018427:Breast Implants / Q000009:adverse effects* / Q000382:microbiology; D020878:Device Removal; D005260:Female; D006099:Granuloma / Q000209:etiology / Q000382:microbiology; D006547:Hernia / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects*; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D014391:Tuberculosis, Miliary / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology
chemical_list: D000995:Antitubercular Agents