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Acute mycobacterial flexor tenosynovitis following accidental bacillus calmette-guerin inoculation in a health care worker: case report.

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Citation: Journal of Hand Surgery - American Volume. 38(2):362-5, 2013 Feb.PMID: 23294648Institution: Curtis National Hand CenterForm of publication: Journal ArticleMedline article type(s): Case Reports | Journal ArticleSubject headings: *BCG Vaccine/ad [Administration & Dosage] | *BCG Vaccine/ae [Adverse Effects] | *Finger Injuries/co [Complications] | *Mycobacterium bovis | *Mycobacterium Infections/di [Diagnosis] | *Needlestick Injuries/co [Complications] | *Occupational Diseases/di [Diagnosis] | *Tenosynovitis/di [Diagnosis] | Acute Disease | Administration, Intravesical | Adult | Antitubercular Agents/tu [Therapeutic Use] | Combined Modality Therapy | Female | Finger Injuries/di [Diagnosis] | Finger Injuries/su [Surgery] | Humans | Mycobacterium Infections/su [Surgery] | Needlestick Injuries/di [Diagnosis] | Needlestick Injuries/su [Surgery] | Occupational Diseases/su [Surgery] | Postoperative Care | Tendons/su [Surgery] | Tenosynovitis/su [Surgery]Year: 2013 Local holdings: Available in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - presentISSN:

0363-5023

Name of journal: The Journal of hand surgeryAbstract: Solutions containing bacillus Calmette-Guerin (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.Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.All authors: Douglas KC, Higgins JP, Mundinger GSFiscal year: FY2013Digital Object Identifier:

http://dx.doi.org/10.1016/j.jhsa.2012.11.011

Date added to catalog: 2016-07-15

Holdings ( 1 )
Title notes ( 3 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	23294648	Available		23294648

Available in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - present

Solutions containing bacillus Calmette-Guerin (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.Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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