Implant infection in a transsexual with renal failure.

Prosthetic breast implants can become a focus of in the left breast and both buttocks, consistent with infection, so 48 h later a whole body gallium-67 citrate infection. Although this is usually a relatively early complication, there has been a single case report of a study was performed (Figure 1b), which confirmed that there was infection in the left breast and the right breast implant becoming infected up to 40 years after surgery [1]. Many microbial organisms have been buttock. The pattern of abnormal uptake being consistent with a peri-implant infection. It is interesting to implicated including Propionibacterium acnes and Staphylococcal species [2]. note that there was marked bilateral central breast uptake seen. This is observed in many women taking A 36-year-old male to female transsexual patient with end-stage renal failure secondary to scleroderma oestrogen based contraceptives and was thought in this case, probably to be due to exogenous oestrogen intake hypertensive renal crisis presented with a 1 week history of feeling generally unwell, nausea and vomiting. She (male to female transsexual ) [3]. The patient received a total of 6 weeks antimicrobial therapy (4 weeks also complained of diarrhoea and chest wall tenderness over a region of previously treated shingles. On examintravenously), made a good recovery with normalization of inflammatory markers. Eleven months later the ination the patient looked unwell with a pyrexia of 38.6°C, was tachycardic and apart from a vesicular, patient had further surgery in the United States, where both breast and buttock prostheses were replaced, she crusting rash in a dermatomal distribution on the right side of the chest there was no clear septic focus. The remains well. patient received haemodialysis via a right internal jugular venous catheter and the exit site showed no References signs of infection. The white cell count was elevated, 16.6×103 cells/ml with a marked neutrophilia and a 1. Petit F, Maladry D, Wether JR, Mitz V. Infection tardive C reactive protein of 215 mg/l. Blood cultures grew d’implant mammaire, complication de perforation colique. Staphylococcus aureus and antibiotic treatment was Revue de la litterature. Place d’un traitement preventif. Annal Chir Plast Esthet 1998; 43: 559–562 switched to intravenous gentamicin and flucloxacillin. 2. Ahn CY, Ko CY, Wager EA, Wong RS, Shaw WW. Microbial The patient improved clinically, with the pyrexia setevaluation: 139 implants removed from symptomatic patients. tling after 14 days of treatment. Plastic Reconstruct Surg 1996; 98: 1225–1259 To determine if there was an underlying osteomyelitis 3. Buscombe J. In Maisey MN, Britton KB, Collier BD, eds, a bone scintigraphy was performed with 550MBq TcInfection in Clinical Nuclear Medicine, Chapman and Hall, London, 1998; 125–137. 99m MDP (Figure 1a). There was no evidence for bone infection but some soft tissue activity was noted