Gluteal Augmentation-Associated Mycobacterial Infection

Excerpt

A 27-year-old woman presented with fatigue and painful lesions on her buttocks. Two months previously, she had undergone gluteal augmentation via autologous fat grafting, also known as a “Brazilian butt lift.” In this technique, fat is aspirated from the abdomen, flanks and thighs, then injected into the buttocks. Cultures from deep tissue biopsy grew Escherichia coli and Corynebacterium amycolatum. She was treated with a course of antibiotics. Three weeks later, her cultures grew Mycobacterium abscessus. On readmission, she was febrile to 38.8 °C, with a leukocyte count of 18,100/mm³ (86% neutrophils). The buttocks were indurated by multiple palpable nodules with purulent drainage (Fig. 1). Contrast-enhanced computed tomography demonstrated innumerable sub-centimeter, fluid-filled cysts with fat stranding in the gluteal soft tissue (Fig. 2). She was started on intravenous amikacin and imipenem, with resolution of her fever and tenderness within a week.

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