Delayed fungal infection following augmentation mammoplasty in an immunocompetent host

Tian HH, Tan SM, Tay KH
Correspondence: Dr Roger Tian Ho Heng, roger_tian@cgh.com.sg

ABSTRACT
We report an unusual case of infection of a breast implant with Trichosporon spp. in an immunocompetent host. There has only been one other reported case in the published literature. The patient was a healthy 27-year-old woman who presented with pain and swelling 17 months after augmentation mammoplasty with a saline implant. Ultrasound-guided aspiration of the effusion surrounding the implant yielded Trichosporon spp. on culture. Oral therapy with fluconazole was commenced, and the implant was salvaged. The nature of this fungi, its mode of transmission and treatment are reviewed. The implications and management of implant infections are also discussed. Physicians should be aware that infection may be delayed, and cultures should be performed for aerobic and anaerobic organisms as well as acid-fast bacilli and fungi. Prompt and appropriate antimicrobial treatment may arrest the infection, sparing the patient the morbidity of a surgical drainage or implant removal.

Keywords: augmentation mammoplasty, fluconazole, fungal infection, mammoplasty complications, saline implant, Trichosporon spp
Singapore Med J 2007; 48(3): 256–258