Mycobacterium chelonae is a rare, atypical nontuberculous bacterium that has been reported to be an underlying cause of persistent wound infections. Although there are several studies highlighting the role of M chelonae as the putative cause of other postoperative wound infections, to our knowledge there ar e no reports of infection following implant placement for repair of an orbital floor fracture. The authors present a unique case describing the management of a persistent postoperative infection in a young, immunocompetent patient with an orbital floor fracture repaired with a Stryker Medpor Titan implant. The patient was initially treated with broad-spectrum antibiotics with minimal clinical improvement. Following culture-proven M chelonae, a second surgical intervention was undertaken to remove the implant and later, a third intervention for scar revision. The patient has remained free of infection utilizing a long-term tailored 2-drug antibiotic regimen. This case emphasizes the need for recognition of M chelonae as a potential pathogen in certain clinical situations and the difficulty in eradicating M chelonae in the context of infected implantable devices. The comprehensive treatment protocol required to ensure adequate therapy is reviewed. Address correspondence and reprint requests to J. Madison Clark, MD, Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of North Carolina Hospitals, 170 Manning Dr., Campus Box #7070, Chapel Hill, NC 27599; E-mail: Madison_clark@med.unc.edu Received 9 September, 2020 Accepted 3 December, 2020 This study was approved by the Institutional Review Board at the University of North Carolina Chapel Hill (20-0558). The authors report no conflicts of interest. © 2021 by Mutaz B. Habal, MD.
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