乳腺假体植入物周围金葡菌感染

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ACR CASE

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History

A 36-year-old woman presents with fever, right breast generalized pain, swelling, and redness lasting one week. She was diagnosed with mastitis several weeks prior secondary to breastfeeding and was treated with oral antibiotics. The mastitis resolved shortly after completion of the antibiotic therapy and she has since stopped breastfeeding. Pertinent past medical history includes bilateral saline breast implants placed 9 years prior.

Question

1.1The patient underwent a diagnostic mammogram of the right breast which revealed a rind of soft tissue surrounding the implant. What is the next most appropriate step in the workup of this patient?

A、Magnification mammography of the right breast

B、Ultrasound with Doppler

C、MR imaging with and without contrast

D、No further workup is necessary

Question

2.1Which of the following is true regarding peri-implant fluid collections? (Check all that apply and click the Submit button.)

A、All peri-implant fluid collections, including small seromas, should be drained because of the risk of infection.

B、Peri-implant infection is very rare in the delayed postoperative setting.

C、naplastic large-cell lymphoma can present as a peri-implant fluid collection.

D、Imaging alone can be used to reliably differentiate between the various causes of peri-implant fluid collections.

E、Saline implants are more likely to develop peri-implant collections than silicone implants.

Question

3.1Choose the most appropriate next step in the management of this patient.

A、Ultrasound-guided fluid aspiration

B、MR imaging with and without contrast

C、Oral antibiotics and outpatient follow-up

D、Surgical consult and immediate breast implant removal

E、No additional workup is recommended

Question

Question

4.1Which group of organisms is most likely responsible for causing a peri-implant infection?

A、Nontuberculous mycobacteria

B、Pseudomonas

C、Staphylococcus

D、Lactobacillus

E、Anaerobes

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解

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