Nontuberculous mycobacterial infection after frontalis sling surgery using silicone rod

PURPOSE The purpose of this study is to report a case of nontuberculous mycobacterial infection after frontalis sling surgery. METHOD A 65-year-old man presented with bilateral painful, erythematous lesions in the brow and upper eyelids. He had a history of frontalis sling surgery for myopathic ptosis 2 years back and all lesions were found localized to the tract of the silicone rod used in the previous frontalis sling surgery. RESULT Incision and drainage of the lesions with microbiological analysis revealed significant growth of coagulase negative staphylococcus and Mycobacterium fortuitum. Sensitivity-based antibiotic treatment with intravenous amikacin was started, but poor response necessitated eventual explantation of both silicone rods for relief of symptoms. Culture of the explanted rods revealed similar results of M. fortuitum infection. Five months after the acute presentation, the patient is asymptomatic. CONCLUSION Nontuberculous mycobacterial infection may be a delayed onset complication in frontalis sling surgery using silicone rods.