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Abdeen Y, Ortiz WJ, Cala-Garcia JD, Cervantes M. Pleural Effusion as a Potential Complication of Foreign Body Reaction to Silicone Breast Implants: A Case Study. Cureus 2023; 15:e38734. [PMID: 37303460 PMCID: PMC10249646 DOI: 10.7759/cureus.38734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Breast augmentation surgery, like any other surgery, has potential complications, including the less common complication of pleural effusion. We present a unique case of a 44-year-old female who developed pleuritic chest pain and shortness of breath 10 days after her breast augmentation surgery, with no prior history of cardiac or autoimmune conditions. The temporal relationship between the surgery and the onset of symptoms suggested a possible direct link to the implants. Imaging showed a small- to moderate-sized left pleural effusion, and pleural fluid analysis revealed findings suggestive of a foreign body reaction (FBR), including evidence of mesothelial and inflammatory cells with a lymphocyte percentage of 44% and monocytes of 30%. The patient received intravenous steroids at a dose of 40 mg every eight hours for three days while hospitalized, followed by a tapered oral dose of steroids upon discharge, for over three weeks. Follow-up imaging studies showed complete resolution of the pleural effusion. The diagnosis of pleural effusion resulting from FBR to silicone gel-filled breast implants involves a clinical history, cytopathological examination, and the exclusion of other potential causes. This case highlights the importance of considering FBR as a potential cause of pleural effusion post-breast augmentation surgery.
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Affiliation(s)
- Yazan Abdeen
- Pulmonary and Critical Care Medicine, HCA (Hospital Corporation of America) Houston Healthcare Pearland, Houston, USA
- Pulmonary and Critical Care Medicine, Pulmonary and Sleep Physicians of Houston, Webster, USA
| | - Wendolin J Ortiz
- General Surgery, Universidad Autónoma de Baja California, Mexicali, MEX
- Pathology, HCA (Hospital Corporation of America) Houston Healthcare Pearland, Houston, USA
| | | | - Mario Cervantes
- Pathology, HCA (Hospital Corporation of America) Houston Healthcare Pearland, Houston, USA
- Pathology, HCA (Hospital Corporation of America) Houston Healthcare West, Houston, USA
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Quaglio G, Pizzol D, Isaakidis P, Bortolani A, Tognon F, Marotta C, Di Gennaro F, Putoto G, Olliaro PL. Breast Tuberculosis in Women: A Systematic Review. Am J Trop Med Hyg 2020; 101:12-21. [PMID: 31115305 DOI: 10.4269/ajtmh.19-0061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Breast tuberculosis (TB) is rarely reported and poorly described. This review aims to update the existing literature on risk factors, clinical presentations, constitutional symptoms, diagnostic procedures, and medical and surgical treatments for breast TB. In all, 1,478 cases of breast TB were collected. Previous history of TB was reported in 19% of cases. The most common clinical appearance of the lesion was breast lump (75%). The most common associated finding was axillary lymphadenitis (33%) followed by sinus or fistula (24%). The most common symptoms were pain and fever, reported in 42% and 28% of cases, respectively. The most used diagnostic method was fine-needle aspiration cytology (32%), followed by biopsy (27%), acid-fast bacteria Ziehl-Neelsen stain (26%), culture (13%), and polymerase chain reaction (2%). These tested positive in 64%, 93%, 27%, 26%, and 58% of cases, respectively. The majority (69%) of patients received a 6-month anti-TB treatment (isoniazid, rifampicin, pyrazinamide, and ethambutol). Surgery consisted of excision in 39% of cases, drainage in 23%, and mastectomy in 5%. The great majority of patients had a positive outcome. It often mimics breast cancer, which makes it difficult to diagnose. Most patients, when diagnosed in time, respond to antitubercular therapy alone.
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Affiliation(s)
- Gianluca Quaglio
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine, and Life Sciences, University of Maastricht, Maastricht, The Netherlands.,Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy.,European Parliamentary Research Services (EPRS), European Parliament, Brussels, Belgium
| | - Damiano Pizzol
- Operational Research Unit, Doctors with Africa CUAMM, Beira, Mozambique
| | - Petros Isaakidis
- Médecins Sans Frontières, Southern Africa Medical Unit (SAMU), Cape Town, South Africa
| | - Arianna Bortolani
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | - Francesca Tognon
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | - Claudia Marotta
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | | | - Giovanni Putoto
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | - Piero L Olliaro
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Special Programme for Research and Training in Tropical Diseases, World Health Organization (WHO/TDR), Geneva, Switzerland
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Parel-Amini L, Uçkay I, Rüegg E, Homsy A, Pittet-Cuénod B, Modarressi A. Les enjeux du tourisme chirurgical dans le domaine de la chirurgie esthétique. ANN CHIR PLAST ESTH 2019; 64:293-297. [DOI: 10.1016/j.anplas.2019.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 06/18/2019] [Indexed: 10/26/2022]
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De Lorenzi C. Successful treatment of acute periprosthetic breast infection with curettage, pulse lavage, and immediate device exchange. Aesthetic Plast Surg 2005; 29:400-3. [PMID: 16075354 DOI: 10.1007/s00266-004-0132-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Acute periprosthetic breast infection in aesthetic surgical patients is a rare event. These patients would be expected to be less tolerant of the standard option of removing the infected implant and waiting 6 months (or possibly more) for tissue conditions to become favourable prior to reinsertion. This report provides confirmatory evidence of a controversial method of management that involves removal of the infected implant, curettage of granulation tissue within the breast implant pocket, pulsed lavage, then switching to a "clean" setup (including gloves, gowns, drapes and instruments) and reinsertion of a new device with suction drainage. The technique allows for immediate replacement of the implant and if successful, obviates the need for any waiting period. Surgeons are encouraged to consider this management option in specific cases where tissue vascularity and patient health are satisfactory.
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