Primary cutaneous inoculation tuberculosis in a healthcare worker as a result of a surgical accident

International Journal of Dermatology
Leonidas TapiasLeonidas Tapias-Vargas

Abstract

In May 2004, a 48-year-old male surgeon, resident in Bucaramanga, Colombia, suffered a superficial cut with a scalpel to the lateral aspect of the mid-phalanx of the second finger of the left hand while performing a pulmonary decortication surgical procedure for tuberculous empyema with pulmonary entrapment. The injury healed normally but, approximately 2 weeks after the event, an erythematous, nonpainful papule of approximately 3 mm in diameter developed, and increased progressively to 7 mm 3 days after its initial appearance. At this time, the papule showed spontaneous secretion of a clear liquid and superficial ulceration (Fig. 1). Approximately 3 weeks after the injury, a Gram stain of the liquid was performed; it showed no bacteria but a moderate leukocyte reaction. Because of the high suspicion of possible tuberculous infection, bacilloscopy of the liquid was performed, and was positive (++) for acid-fast bacteria (Fig. 2). The liquid was cultured and grew Mycobacterium tuberculosis. The culture was sent to the Laboratory of Mycobacteria at the National Institute of Health, Bogota, Colombia for drug resistance testing. Susceptibility was demonstrated against streptomycin, isoniazid, rifampicin, and ethambutol. During this...Continue Reading

References

Nov 4, 1965·The New England Journal of Medicine·K M Heilman, C Muschenheim
Mar 21, 2002·The Australasian Journal of Dermatology·I KokcamM Z Doymaz
Jun 19, 2002·American Journal of Clinical Dermatology·Joseph BarbagalloJeffrey M Weinberg
Aug 2, 2003·International Journal of Dermatology·Charandeep KaurA J Kanwar
Aug 28, 2003·Journal of the European Academy of Dermatology and Venereology : JEADV·A Ghorpade

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Citations

Apr 11, 2015·Revista Da Sociedade Brasileira De Medicina Tropical·Fatma Sule AfsarIlhan Afsar
Sep 11, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Daniel P McQuillenLawrence P Martinelli
Aug 17, 2010·Annals of Dermatology·Jin Ki KimMoon Soo Yoon

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