Aesthetic Plastic Surgery

, Volume 36, Issue 1, pp 153–159

Implant Infection After Augmentation Mammaplasty: A Review of the Literature and Report of a Multidrug-Resistant Candida albicans Infection

  • Luca A. Dessy
  • Federico Corrias
  • Francesco Marchetti
  • Marco Marcasciano
  • Andrea F. Armenti
  • Marco Mazzocchi
  • Bruno Carlesimo
Case Report

DOI: 10.1007/s00266-011-9777-x

Cite this article as:
Dessy, L.A., Corrias, F., Marchetti, F. et al. Aesth Plast Surg (2012) 36: 153. doi:10.1007/s00266-011-9777-x

Abstract

Background

Implant breast augmentation is one of the most frequently performed surgical procedures, and fungal infection still is considered exceptional. This report presents a case of bilateral breast implant infection by multidrug-resistant Candida albicans treated with a targeted antifungal therapy.

Methods

A young woman presented with breast pain and asymmetry as well as implant superficialization in the left breast 3 years after bilateral tuberous breast correction with implant insertion. She did not report any trauma to the chest wall or recent systemic infections. The breast was evaluated through mammary compliance analysis and magnetic resonance imaging (MRI).

Results

At surgery, both implants showed capsule contracture and were surrounded by a gelatinous yellow-brown and turbid fluid, which was sent for microbial and fungal analysis. A bilateral capsulectomy was performed. After copious irrigation of the subglandular pockets, submuscular pockets were created, and implants were substituted. Culture swabs tested positive for C. albicans and showed drug resistance to amphotericin B, fluconazole, itraconazole, and voriconazole on the fungal antibiogram. Targeted antifungal therapy with caspofungin was administrated in association with oral antibiotic therapy. Follow-up assessment at 1, 3, 6, 12, and 24 months did not show any infection or contracture relapse.

Conclusions

This is the first report in the literature on a breast implant infection by a multidrug-resistant C. albicans. The study focused on the association between fungal contamination and capsular contracture and investigated the importance of a fungal antibiogram in cases of suspected prosthesis infection for performance of a targeted antifungal treatment.

Keywords

Augmentation mammaplastyBreast implantCandida infection

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2011

Authors and Affiliations

  • Luca A. Dessy
    • 1
    • 3
  • Federico Corrias
    • 1
  • Francesco Marchetti
    • 1
  • Marco Marcasciano
    • 1
  • Andrea F. Armenti
    • 1
  • Marco Mazzocchi
    • 2
  • Bruno Carlesimo
    • 1
  1. 1.Department of Plastic and Reconstructive Surgery“Sapienza” University of RomeRomeItaly
  2. 2.Department of Plastic and Reconstructive SurgeryUniversity of PerugiaPerugiaItaly
  3. 3.AsseminiItaly