Acute mycobacterial flexor tenosynovitis following accidental bacillus Calmette-Guérin inoculation in a health care worker: Case report

Gerhard S. Mundinger, Keith C. Douglas, James Patrick Higgins

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)362-365
Number of pages4
JournalJournal of Hand Surgery
Volume38
Issue number2
DOIs
Publication statusPublished - Feb 2013

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Keywords

  • Bacillus Calmette-Guérin
  • flexor tenosynovitis
  • mycobacterial infection
  • needlestick
  • self-inoculation

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

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