Introduction: This case details Mycobacterium chelonae infection after combination facial autologous fat transfer with subdermal microneedling and fractional radiofrequency skin resurfacing successfully treated with novel tedizolid therapy. Methods: Case report, collection and evaluation of protected patient health information were HIPPA compliant. Results: A 59-year-old woman presented from an outside facility three weeks after bilateral lower eyelid autologous fat transfer, subdermal micro-needling and fractional radiofrequency skin resurfacing. Two weeks after surgery, she developed unilateral leftsided swelling and a small erythematous nodule. After failing outpatient antibiotic therapy with clindamycin and trimethoprimsulfamethoxazole, she presented to the emergency room for imaging and intravenous antibiotics for pre-septal cellulitis. Maxillofacial computerized tomography with contrast demonstrated left preseptal cellulitis without frank abscess. After poor response to intravenous vancomycin and ampicillin/sulbactam, her wound was cultured in an area of fluctuance and revealed Myocobacterium chelonae. She was transitioned to an outpatient regimen of clarithromycin and tedizolid for a total of 4 months with resolution of her infection (Figure 1). No recurrence has been detected 3 months after discontinuation. Conclusions: This case highlights the need for vigilance and a broad differential in delayed post-operative wound infections including non-tuberculous mycobacterium infections. Additional caution may need to be exercised when performing combination autologous fat transfers with subdermal micro-needling procedures. When encountered, Mycobacterium chelonae infections may respond well to prolonged combination therapy with oral clarithromycin and tedizolid.
Cheng O, Kally P, Beaulieu. Periocular non-tuberculous mycobacterium infection after combination autologous fat transfer with subdermal micro-needing and fractional radiofrequency skin resurfacing. Poster presented at: American Society of Ophthalmic Plastic & Reconstructive Surgery, Oculofacial Plastic Surgery. 52nd Annual Fall Scientific Symposium. New Orleans, LA; 2021 November 11-12.