COVID-19 Infection or Buttock Injections? The Dangers of Aesthetics and Socializing During a Pandemic
Categoria dell'articolo: Case report
Pubblicato online: 09 feb 2022
Pagine: 49 - 54
Ricevuto: 14 apr 2021
Accettato: 20 nov 2021
DOI: https://doi.org/10.2478/jccm-2021-0043
Parole chiave
© 2021 Derrick Anthony Cleland, Clarence H. H. Tsai, Joslyn Vo, Dafne Moretta, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Introduction
Silicone (polydimethylsiloxane) injections are used for cosmetic augmentation. Their use is associated with life-threatening complications such as acute pneumonitis, alveolar hemorrhage, and acute respiratory distress among others [1,2]. We report a case of a Hispanic woman who developed severe respiratory distress syndrome after gluteal silicone injections.
Case Presentation
A 44-year-old Hispanic female presented to the Emergency Department complaining of progressive dyspnea on exertion for two weeks. Chest imaging revealed patchy bibasilar airspace opacities of peripheral distribution. Labs were significant for leukocytosis, elevated PT, D-dimer, lactate dehydrogenase, and fibrinogen, concerning for COVID-19, however SARS-CoV-2 testing was negative multiple times. The patient later became encephalopathic, hypoxemic, and eventually required intubation. Further history uncovered that the patient had received illicit gluteal silicone injections a few days prior to her onset of symptoms. The patient was diagnosed with silicone embolism syndrome (SES) and initiated on high dose intravenous methylprednisolone [1].
Case Discussion
Patients from lower socioeconomic backgrounds utilize illicit services to receive silicone injections at minimal costs. This leads to dangerous outcomes. The serology and imaging findings observed in our case have similarities to the typical presentation of COVID-19 pneumonia making the initial diagnosis difficult. This case serves as a cautionary tale of the importance of thorough history taking in patients with concern for COVID-19.