Mycobacterium avium Infection in a Domestic Shorthair Cat Following Subdermal Hyaluronic Acid Filler Injection.

Non-tuberculous mycobacterial infection can occur post-filler injection in cats; intralesional antibiotics may be necessary.

This case report describes the first documented Mycobacterium avium subsp. hominissuis infection in a domestic cat following subdermal hyaluronic acid filler injection. A five-year-old spayed female domestic shorthair presented with left inferior eyelid swelling and mandibular lymphadenomegaly approximately two weeks post-injection. Culture and PCR confirmed mycobacterial infection resistant to fluoroquinolones and rifampin. The patient demonstrated poor clinical response to oral clarithromycin and isoniazid intolerance. Treatment success was achieved through adjunctive intralesional amikacin injections (12.5 mg/kg per treatment) administered to the affected eyelid and lymph node. Mycobacterial PCR became negative four months post-diagnosis, with antibiotic therapy completed at six months and no recurrence at 18-month follow-up. This case highlights that non-tuberculous mycobacterial infections, previously recognized complications of subdermal fillers in humans, can occur in feline patients. The findings suggest that conventional oral antibiotics alone may prove insufficient for treating such infections, emphasizing the value of extended therapeutic courses and alternative drug delivery methods including intralesional injection.

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