Successful Management of Infected Facial Filler with Brucella

• Published in: Aesthetic plastic surgery 2018-10, Vol.42 (5), p.1388-1392
• Main Authors: Alshaer, Zahra, Alsaadi, Yazeed, Mrad, Mohamed Amir
• Format: Article
• Language: English
• Subjects: Abscess - drug therapy; Abscess - etiology; Abscess - physiopathology; Anti-Bacterial Agents - therapeutic use; Antibiotics; Brucella - isolation & purification; Brucellosis; Brucellosis - drug therapy; Brucellosis - etiology; Brucellosis - physiopathology; Dermal Fillers - adverse effects; Face; Female; Follow-Up Studies; Humans; Injections; Injections, Subcutaneous - adverse effects; Medicine; Medicine & Public Health; Middle Aged; Original Article; Otorhinolaryngology; Plastic Surgery; Risk Assessment; Skin Diseases, Bacterial - drug therapy; Skin Diseases, Bacterial - etiology; Skin Diseases, Bacterial - physiopathology; Surgical outcomes; Treatment Outcome
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/s00266-018-1173-3

Background The widespread desire to maintain youth and beauty with minimally invasive procedures made the use of soft tissue fillers an attractive option to correct numerous aesthetic problems. However, many complications have emerged recently especially with the use of non-FDA-approved permanent materials. In this case report, we are demonstrating the effective management of a patient with Brucella isolated from a facial abscess at the site of prior permanent filler injection done 17 years ago. Methods A 56-year-old woman presented complaining of painful swelling of the right cheek after a failed trial of filler evacuation and intralesional corticosteroid injection. The patient was interviewed carefully, and physical examination was performed, followed by culture and imaging. Results The patient had a facial abscess that was complicated by parotid infiltration by Brucella . Eventually she was managed successfully by anti- Brucella antibiotics for 6 months with no further complaints. A review of causative organisms in the literature along with recommendations for management is discussed. Conclusion Permanent fillers have shown many complications that can occur even years after injection. Therefore, physicians should be careful when using permanent fillers and should restrict their use to certain situations. Moreover, rare infections must be kept in mind and careful history, including travel history and animal contact, needs to be considered particularly in the unusual scenarios. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .