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International Society for Infectious Diseases
[1]
Date: Sun 7 Mar 2010
Source: The Newark (NJ) Star-Ledger [edited]
Officials said 6 women from the Essex County (NJ) area who wanted
fuller bottoms ended up in hospitals after receiving
buttocks-enhancement injections containing the same material
contractors use to caulk bathtubs.
The women checked into hospitals in the county after their
procedures, apparently administered by unlicensed providers, went
horribly wrong, state health officials said. The women underwent
surgery and were given antibiotics. No arrests have been made.
Different from medical-grade silicone, the substance used in the
botched procedures was believed to be a diluted version of non
medical-grade silicone.
"The same stuff you use to put caulk around the bathtub," said Steven
M Marcus, executive and medical director of the New Jersey Poison
Information and Education System, who learned about the bizarre
procedures through a committee he sits on that monitors outbreaks in
the metropolitan area.
Gregory Borah, chief of plastic surgery at Robert Wood Johnson
University Hospital in New Brunswick, also president of the New
Jersey Society of Plastic Surgeons, said the botched procedures
underscore the need for patients who seek augmentation to have it
administered by a licensed professional in a sterile setting. A
plastic surgeon doing buttocks augmentation would make an incision to
develop a pocket underneath the muscle and shape the buttocks with
inert medical-grade silicone, Borah said. He noted it is a relatively
uncommon procedure in most practices and that he has done only 2 in
his 24-year career.
By the time he tells patients of the potential risks, from
anesthesia, scarring, and silicone shifting when patients sit down,
they often change their minds.
Breast and cheek augmentations are the most common procedures, he
noted. Borah said buttock augmentation is more popular in some
cultures than others.
The state Department of Health and Senior Services did not identify
the women or release any details about their ethnicity. It also did
not say where the "unlicensed medical provider or providers"
performed their procedures.
"Fortunately, these women are being treated and are recovering," said
Tina Tan, the state epidemiologist. "But there is the potential for
more serious complications if these infections are not treated early
and properly."
Investigators have not determined if the 6 cases, which began to be
reported in mid-February 2010, are related, but they have stoked
concern among officials that such injuries are more common than
previously thought. Health officials issued an alert to state
hospitals and doctors about the cases and the potential for more
victims.
[Byline: Rohan Mascarenhas, Mike Frassinelli]
--
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[2]
Date: Wed 10 Mar 2010
Source: New York City Department of Health and Mental Hygiene [edited]
The New York City Department of Health and Mental Hygiene (DOHMH) has
been notified of 6 cases of cellulitis/subcutaneous abscesses in New
Jersey residents who received injections of unknown substances into
the buttocks for cosmetic purposes. There have been no cases reported
among New York City residents, but 1 patient from New Jersey reported
receiving her injections in a private residence in New York City.
All of the cases occurred in young women who received the cosmetic
injections between November 2009 and February 2010. The 6 patients
presented with buttock cellulitis and abscesses requiring incision
and drainage approximately 2 to 4 weeks following their injections;
all were hospitalized. No deaths have been reported, but some
patients have required long-term outpatient antibiotic therapy.
The New Jersey Department of Health and Senior Services and local
health officials in New Jersey are actively investigating the cases,
and preliminary information suggests the injections may have been
performed by unlicensed individuals. _Nocardia_ spp. has been
identified in cultures obtained from abscesses from 3 of the 6 New
Jersey cases; cultures are pending still for the other cases.
Previous incidents of infections associated with cosmetic procedures
performed by unlicensed providers have occurred in New York City,
though with different organisms. The NYC DOHMH investigated a cluster
of cutaneous _Mycobacterium abscessus_ infections in 2002 and a case
of cutaneous _Mycobacterium fortuitum_ infection in 2005.
_Nocardia_ include a number of species normally found in soil,
organic matter, and water. Although health care providers evaluating
individuals with infections following cosmetic injections should
consider typical organisms such as streptococci and staphylococci,
atypical organisms such as _Nocardia_ spp. and _Mycobacterium_ spp.
also should be included in the differential. These atypical organisms
can present with more indolent skin lesions and may not respond to
usual empiric antimicrobial regimens. Strong consideration should be
given to consultation with an infectious diseases specialist when
managing patients infected with _Nocardia_ spp. and other atypical
organisms.
--
Communicated by:
ProMED-mail
[Nocardiosis is generally seen in humans when an alteration in the
normal immune state is present especially following solid organ
transplantation or with chronic granulomatous disease. Despite the
severe cellular immunosuppression in end stage HIV infection,
nocardiosis seems underrepresented in the spectrum of infection seen
in this cohort.
An aerobic gram-positive bacillus that is also partially acid fast
and be initially confused with mycobacteria, _Nocardia_ can also
cause a cutaneous infection reminiscent of the disease caused by
sporotrichosis, an environmental fungus. - Mod.LL]
[The state of New Jersey can be located on the HealthMap/ProMED-mail
interactive map of the US at
Essex County can be located on the map at
[see also:
Anthrax, human - UK (06): (Scotland) 20100310.0780
2009
----
Anthrax, human - UK: (Scotland) heroin users 20091217.4270
Mycobacterium fortuitum, breast implant - Brazil: (SP) 20090112.0121
2007
----
Tetanus, injection-related - USA (NY) ex Dominican Republic (03)20070613.1927
Tetanus, injection-related - USA (NY) ex Dominican Republic (02) 20070612.1915
Tetanus, injection-related - USA (NY) ex Dominican Republic 20070611.1904
2004
----
Mycobacterium abscessus - USA ex Dominican Republic (03) 20040621.1650
Mycobacterium abscessus - USA ex Dominican Republic (02) 20040504.1225
Mycobacterium abscessus - USA ex Dominican Republic 20040501.1200
2003
----
Mycobacterium abscessus - USA (New York) 20030116.0137]
...................................ll/mj/lm
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