Successful use of locally applied polyhexamethylene biguanide as an adjunct to the treatment of fungal osteomyelitis.

Fungal osteomyelitis is rare in immunocompetent patients and is often difficult to cure, even with optimal medical and surgical management. The authors present two cases of fungal osteomyelitis in which the common swimming pool cleaner, polyhexamethylene biguanide, was used successfully as an adjunct to standard surgical and medical treatment. Also presented is a literature review on the use of polyhexamethylene biguanide for this indication. The authors recommend that this safe and well-tolerated compound be considered as part of the treatment for fungal osteomyelitis.

L'ostéomyélite fongique, rare chez les patients immunocompétents, est souvent difficile à guérir, malgré une prise en charge médicale et chirurgicale optimale. Les auteurs présentent deux cas d'ostéomyélite fongique dans lesquels le polyhexaméthylène biguanide, un nettoyeur pour piscine courant, a été utilisé avec succès en plus du traitement chirurgical et médical. Ils présentent également une analyse bibliographique de l'utilisation de polyhexaméthylène biguanide pour cette indication. Les auteurs recommandent d'envisager d'utiliser ce composant sécuritaire et bien toléré dans le cadre du traitement de l'ostéomyélite fongique.

Post Liposuction Mycobacterium Abscessus Surgical Site Infection in a Returned Medical tourist Complicated by a Paradoxical Reaction During Treatment.

Rapidly growing mycobacterial skin and soft tissue infections are known to complicate cosmetic surgical procedures. Treatment consists of more surgery and prolonged antibiotic therapy guided by drug susceptibility testing. Paradoxical reactions occurring during antibiotic therapy can further complicate treatment of non-tuberculous mycobacterial infections. We report a case of post liposuction Mycobacterium abscessus surgical site infection in a returned medical tourist and occurrence of paradox during treatment.