A unique case report of a high-pressure paint injection injury of the hand with associated carbapenemase resistant Pseudomonas aeruginosa infection

Journal of Surgical Case Reports
Kurt BargerMichael French

Abstract

High pressure injection injuries to the hand should not be taken lightly as urgent surgical debridement is required to ensure favorable outcomes. Empiric antibiotic administration is recommended; however, few studies focus on the secondary infection risk associated with these high pressure injection injuries. We present a rare case of a patient presenting with carbapenem resistant Pseudomonas aeruginosa following a high pressure paint gun injury of the thumb. Urgent surgical debridement with administration of broad-spectrum antibiotic coverage for both gram-negative and gram-positive bacteria is recommended. The injection of foreign materials can cause extensive tissue damage and immunosuppression facilitating growth of opportunistic bacteria that are often rare in healthy adults. We advocate for obtaining cultures at initial debridement to optimize treatment in these unique and rare injection injuries. Concerns should be raised as carbapenem resistant bacteria become more prevalent in the community.

References

Aug 8, 2006·Journal of Orthopaedic Trauma·Christopher J Hogan, Robert T Ruland
Apr 23, 2008·Strategies in Trauma and Limb Reconstruction·N Verhoeven, R Hierner
Sep 10, 2008·Hand : Official Journal of the American Association for Hand Surgery·Santiago A Lozano-CalderónDavid Ring
Oct 1, 2013·Plastic and Reconstructive Surgery·Simon L Amsdell, Warren C Hammert
Jun 9, 2016·BioMed Research International·Sirijan Santajit, Nitaya Indrawattana
Jun 26, 2017·International Journal of Antimicrobial Agents·Ana M KellyElaine L Larson
Mar 22, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Sancho Rodríguez-VillarCarlos Pilasi Menichetti

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BETA
amputation

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Carbapenems (ASM)

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.

Carbapenems

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.

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