Saksenaea erythrospora infection after medical tourism for esthetic breast augmentation surgery.
BACKGROUND
Mucormycosis caused by Saksenaea erythrospora is rarely reported in humans. Three previous cases have been reported in the literature, two associated with trauma (a sailing accident in Argentina and a combat trauma in Iraq) and one as a cause of invasive rhinosinusitis (India), all in immunocompetent patients . The first case of mucormycosis following esthetic surgery, associated with medical tourism, is reported herein.


METHODS
A case study of an S. erythrospora infection in an immunocompetent woman after the completion of esthetic surgery (dermolipectomy and breast augmentation) is reported. The infection presented as a rapidly progressive necrotizing infection of the skin and soft tissue, which required a bilateral mastectomy and extensive surgical debridement associated with prolonged antifungal therapy. The organism was identified phenotypically and confirmed biologically after rDNA amplification and sequencing. Two months later, the patient remains hospitalized awaiting the start of reconstructive surgeries. The present case is, to the best of the authors' knowledge, the first report from Colombia.


CONCLUSIONS
Mucormycosis should be considered in the differential diagnosis of necrotizing infections of the skin and soft tissue that evolve rapidly after cosmetic surgery performed in tropical or subtropical countries.
Centro de Investigaciones Microbiológicas del Cesar (CIMCE), Clínica Médicos S.A., Valledupar, Colombia.
José Y
JY
Rodríguez
Centro de Investigaciones Microbiológicas del Cesar (CIMCE), Clínica Médicos S.A., Valledupar, Colombia.
Gerson J
GJ
Rodríguez
Departamento de Microbiología, Universidad Popular del Cesar, Valledupar, Colombia.
Soraya E
SE
Morales-López
Centro de Investigaciones Microbiológicas del Cesar (CIMCE), Clínica Médicos S.A., Valledupar, Colombia.
Carlos E
CE
Cantillo
Département de Parasitologie-Mycologie, Université de Nantes, Nantes Atlantique Universités, EA1155-IICiMed, Faculté de Pharmacie, Nantes, France; Laboratoires de Parasitologie-Mycologie, Institut de Biologie, CHU de Nantes, France.
Patrice
P
Le Pape
Unidad de Enfermedades Infecciosas, Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia. Clínica Universitaria Colombia, Av calle 127 No. 20-78, Oficina 508, Colsanitas S.A., Bogotá, Colombia. Electronic address: caalvarezmo@unal.edu.co.
Carlos A
CA
Álvarez-Moreno
D000328:Adult; D004954:Esthetics; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects*; D057193:Medical Tourism; D009090:Mucorales / Q000302:isolation & purification; D009091:Mucormycosis / Q000209:etiology*
Esthetic surgery; Medical tourism; Mucormycosis; Saksenaea