Atypical mycobacteria periprosthetic infections--diagnosis and treatment.

The presence of atypical mycobacteria has been reported in increasing numbers following augmentation mammaplasty in the United States. Prior to this work, there was no effective method for obtaining a satisfactory result with a retained prosthesis in a reasonable length of time. Early detection and prompt institution of this newly developed protocol of local and systemic antibiotic therapy, followed by surgical curettage and wound sterilization, have been successful in these three cases. This method has enabled patients to obtain a short course of therapy (in the most recent cases, less than 1 month) and a satisfactory aesthetic result. In spite of exhaustive efforts to pinpoint the etiology of the infection, the exact way in which the infecting agent has its entrance--whether by contaminated material or airborne--is as yet unknown. It is apparent from the patients treated that these remain as isolated infections, without systemic manifestations. Follow-up on these patients is in excess of 1 year, with soft, normal-appearing, Baker Class I breasts. With variations in the drugs utilized, this method is currently being expanded to treat other types of periprosthetic breast infections satisfactorily.