Infection with Mesotherapy coming from Disfavourable Treatment Environments

An outbreak of Mycobacterium fortuitum cutaneous infection associated with mesotherapy.

Quiñones C, Ramalle-Gómara E, Perucha M, Lezaun ME, Fernández-Vilariño E, García-Morrás P, Simal G.

J Eur Acad Dermatol Venereol. 2009 Oct 15.

• The risk of mycobacterium fortuitum infections is frequent in medical practices attached with beauty salons that offer pedicure, liposuction, manicure and mesotherapy (6 other articles are quoted by the authors in this article).

• The authors describe 39 (28.3%) culture proven (after clinical suspicion) of mycobacterium fortuitum infections out of 138 women receiving mesotherapy over a 8 month period (January to end of August 2007) in Spain:

1. Mycobacterium fortuitum is a non  pigmented rapidly growing mycobacterium classified as Runyon group IV.
2. The infections came from a single beauty salon with one physician. Only patients receiving mesotherapy were infected and the infections stopped appearing when this practice stopped.
3. The precise source of the mycobacterium in this case was not identified. It was unlikely during the injection process as the vials where the substances were drawn were sterile.
4. This mycobacteria is commonly found on floors, soil and in tap-water (chlorinated or not). Due to the fact that the centre was associated with a beautician platform, various additional services were offered (facial treatments, hair removal…). This implies the presence of several containers with residual standing water.

• To conclude, physicians performing mesotherapy should know that this mycobacteria is ubiquitous and can easily contaminate towels, cotton swabs and medical instruments. This bacteria can survive in standing water and be transmitted through skin to skin contact. Sterile technique, training are needed as well as a low risk contamination environment. Patients should be made aware of the risk otherwise.