Acute Mycobacterial Flexor Tenosynovitis Following Accidental Bacillus Calmette-Gu¨¦rin Inoculation in a Health Care Worker: Case Report

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• 作者：Gerhard S. Mundinger ; MD ; Keith C. Douglas ; MD ; James P. Higgins ; MD ; ^{anne.mattson@medstar.net}
• 关键词：Bacillus Calmette-Gué ; rin ; flexor tenosynovitis ; mycobacterial infection ; needlestick ; self-inoculation
• 刊名：The Journal of Hand Surgery
• 出版年：2013
• 出版时间：February, 2013
• 年：2013
• 卷：38
• 期：2
• 页码：362-365
• 全文大小：955 K

文摘

Solutions containing bacillus Calmette-Gu¨¦rin (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.