• Aisha Shaikh and Lubna Mushtaque Vohra.
• Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan.
• J Coll Physicians Surg Pak. 2020 May 1; 30 (5): 537-540.

AbstractMycobacterium abscessus is a rapidly growing non-tuberculous, multi-drug resistant mycobacterium (NTM). Its common clinical presentation includes pulmonary infection followed by wide spectrum of skin and soft tissue infections. Chronic breast conditions, such as peri-ductal mastitis are rarely caused by NTM. Due to an intrinsic and acquired drug resistance to conventional antibiotics and anti-tuberculous therapy, it is often managed with a combination of antibiotics with or without surgical adjuncts. It is important to consider NTM in patients with chronic mastitis who show suboptimal response to initial broad-spectrum antibiotics, and especially when symptoms recur after complete resolution. This case report describes peri-ductal mastitis caused by mycobacterium abscessus in a 32-year female presenting with a history of painful breast lump and blood stained discharge. With initial diagnosis of nonspecific abscess, she received antibiotic therapy for 4 days at community healthcare setting without promising response. Subsequently, she was diagnosed as a case of peri-ductal mastitis for which quadrantectomy was performed; and surprisingly mycobacterium abscessus was identified on AFB culture. Full recovery was obtained with combination of antibiotics for prolonged period due to frequent relapses. Key Words: Mastitis, Mycobacterium abscessus, Non-tuberculous mycobacteria.

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