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Mixed Infection of an Atypical Mycobacterium and Aspergillus Following a Cryopreserved Fat Graft to a Face

Kim, Seong Kee MD*†; Kim, Han Joon MD*; Hwang, Kun MD, PhD*‡

doi: 10.1097/SCS.0b013e31828f27ee
Clinical Studies

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.

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.

Received November 23, 2012.

Accepted for publication February 23, 2013.

Address correspondence and reprint requests to Kun Hwang, MD, PhD, Department of Plastic Surgery and the Center for Advanced Medical Education by the BK21 Project, Inha University School of Medicine, 7-206 Sinheung-dong, Jung-gu, Incheon, 400-711, Korea; E-mail:

The authors report no conflicts of interest.

© 2013 by Mutaz B. Habal, MD.