TY - JOUR
T1 - Acute mycobacterial flexor tenosynovitis following accidental bacillus Calmette-Guérin inoculation in a health care worker
T2 - Case report
AU - Mundinger, Gerhard S.
AU - Douglas, Keith C.
AU - Higgins, James P.
PY - 2013/2
Y1 - 2013/2
N2 - Solutions containing bacillus Calmette-Guérin (BCG), a live attenuated form of Mycobacterium bovis or Mycobacterium tuberculosis, commonly are injected intravesically to treat tumors of the urinary bladder. We report a case of acute mycobacterial flexor tenosynovitis in a health care worker who inadvertently inoculated her finger via needlestick while preparing BCG solution for intravesicular administration. She was treated successfully with immediate operative intervention followed by 6 months of antimycobacterial antibiotics. Of 3 previous reports of hand infections following self-inoculation with BCG solutions, this case is unique owing to rapid onset of acute mycobacterial flexor tenosynovitis and positive intraoperative mycobacterial cultures. Needlesticks with BCG-containing solutions, especially into the flexor tendon sheath, should be treated with timely surgical debridement and appropriate antimycobacterial management.
AB - Solutions containing bacillus Calmette-Guérin (BCG), a live attenuated form of Mycobacterium bovis or Mycobacterium tuberculosis, commonly are injected intravesically to treat tumors of the urinary bladder. We report a case of acute mycobacterial flexor tenosynovitis in a health care worker who inadvertently inoculated her finger via needlestick while preparing BCG solution for intravesicular administration. She was treated successfully with immediate operative intervention followed by 6 months of antimycobacterial antibiotics. Of 3 previous reports of hand infections following self-inoculation with BCG solutions, this case is unique owing to rapid onset of acute mycobacterial flexor tenosynovitis and positive intraoperative mycobacterial cultures. Needlesticks with BCG-containing solutions, especially into the flexor tendon sheath, should be treated with timely surgical debridement and appropriate antimycobacterial management.
KW - Bacillus Calmette-Guérin
KW - flexor tenosynovitis
KW - mycobacterial infection
KW - needlestick
KW - self-inoculation
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U2 - 10.1016/j.jhsa.2012.11.011
DO - 10.1016/j.jhsa.2012.11.011
M3 - Article
C2 - 23294648
AN - SCOPUS:84872918103
SN - 0363-5023
VL - 38
SP - 362
EP - 365
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
IS - 2
ER -