Surgical Site Infection Owing to Mycobacterium mageritense After Immediate Breast Reconstruction Using a Deep Inferior Epigastric Perforator Flap.

Abstract

Mycobacterium mageritense is a rare, rapidly growing, nontuberculosis mycobacterium that belongs to type IV of the rapidly growing mycobacteria. These bacteria are found in soil and water, and cause localized skin and soft tissue infections; however, they are challenging to culture, leading to diagnostic delays. To our knowledge, there have been 12 reported cases of surgical site infections (SSIs) caused by M. mageritense, with only 2 cases following breast reconstruction. A 51-year-old woman underwent nipple-sparing mastectomy and immediate breast reconstruction using a deep inferior epigastric perforator flap for invasive ductal carcinoma of the left breast. One month after surgery, she developed an SSI caused by M. mageritense. Despite initial outpatient treatment, the infection persisted, requiring multiple hospitalizations, administration of intravenous antibiotics, and several debridements under general anesthesia. Negative pressure wound therapy and a coordinated approach among various medical specialties are essential for managing infections. The patient experienced side effects from prolonged antibiotic use but eventually exhibited no signs of infection recurrence. This case highlights the challenges in diagnosing and treating M. mageritense SSIs, emphasizing the need for comprehensive surgical and medical management, together with patient-centered care, to effectively manage long-term treatment.