Infection With Mycobacterium chelonae Following Autologous Facial Fat Grafting: A Case Report and Review of Literature.

BACKGROUND: Autologous fat grafting is commonly used in cosmetic dermatology, but it can cause serious complications, including nontuberculous mycobacterial infections when done under unsterile conditions. CASE PRESENTATION: We report a 39-year-old woman who developed multiple discharging facial abscesses 1 month after undergoing autologous fat grafting in an unauthorized cosmetic clinic. Initial empiric oral therapy with clarithromycin, minocycline, and rifampin failed, prompting intravenous antibiotic therapy. During the hospitalization, she developed loss of consciousness, seizure, cerebral edema, and cavernous sinus thrombosis, followed by corticosteroid-induced adrenal suppression. When visiting our clinic, biopsy, PCR, and culture were performed, which confirmed infection with Mycobacterium chelonae (M. chelonae) after prolonged multidrug therapy with intravenous amikacin, imipenem, linezolid, and clarithromycin, and abscess drainage; the infection resolved. At 6 months of follow-up, no recurrence was observed, although residual scarring persisted. CONCLUSION: This case highlights a rare and severe systemic complication of Mycobacterium chelonae infection following cosmetic fat grafting, underscoring the need for strict aseptic technique, awareness of regional antimicrobial resistance, and better regulation of aesthetic procedures.