Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-18T18:54:21.847Z Has data issue: false hasContentIssue false
  • English
  • Français

Injection Site Abscesses Caused by Mycobacterium Chelonei

Published online by Cambridge University Press:  02 January 2015

David H. Gremillion ,
Sara B. Mursch  and
Charles J. Lerner
David H. Gremillion*
Affiliation:
Wilford Hall USAF Medical Center, Lackland Air Force Base, Texas
Sara B. Mursch
Affiliation:
Wilford Hall USAF Medical Center, Lackland Air Force Base, Texas
Charles J. Lerner
Affiliation:
Wilford Hall USAF Medical Center, Lackland Air Force Base, Texas
*
SGHMMI, Wilford Hall USAF Medical Center, Lackland AFB, TX 78236
Get access Rights & Permissions [Opens in a new window]

Abstract

Subcutaneous abscesses occurred at hip and deltoid injection sites in 13 student nurse assistants following practice injections. Mycobacterium chelonei was isolated from three cases and was the presumptive pathogen in other temporally clustered cases with similar clinical findings. A 1,000 cc bottle of 0.9 N saline used as a source for practice injection solution was the apparent source of the organism.

Presenting findings included tenderness (7), swelling (7), fever (3), adenopathy (1) and weight loss (1). All cases were characterized by long incubation periods (6 to 16 weeks) and delayed resolution (mean 8.8 months), and required surgical drainage or wedge excision for therapy. Antituberculous therapy was administered in three cases. Complications were limited to scarring in seven cases with keloid formation in two and persistent pain in three cases. This outbreak reinforces the importance of penetrating trauma in this cutaneous mycobacterial infection and emphasizes the emergence of this organism as an important nosocomial pathogen.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 4 , Issue 1 , February 1983 , pp. 25 - 28
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1983

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Wolinsky, E, Nontuberculous mycobacteria and assoc iated diseases. Am Rev Respir Dis 1979;119:107–159.Google Scholar
2.Hand, WL, Sanford, JP, Mycobacterium fortuitum — A human pathogen. Ann Intern Med 1970;73:971–977.CrossRefGoogle ScholarPubMed
3.Inman, PM, Beck, A, Brown, ACet al: Outbreak of injection abscesses due to M. abscessus. Arch Dermatol 1969;100:141.CrossRefGoogle Scholar
4.Guerra, Brigida, et alv City Medical College Ine, 225th Judicial District, Texas, 77-CI-15656.Google Scholar
5.Moore, M, Frerichs, JB, An unusual acid-fast infection of the knee with subcutaneous abscess-like lesions of the gluteal region. J Invest Dermatol 1953;20:133–168.CrossRefGoogle ScholarPubMed
6.Offer, RC, Karlson, AG, Spittell, JA Jr, Infection caused by Mycobacterium fortuitum. Mayo Clin Proc 1971;46:747.Google ScholarPubMed
7.Gangadharam, PR, Hsu, KHK, Mycobacterium abscessus infection in a puncture wound. Am Rev Respir Dis 1972;106:275.CrossRefGoogle Scholar
8.Herndon, JH, Dantzker, DR, Lanoue, AM, Mycobacterium fortuitum infections involving the extremities. J Bone Joint Surg 1972;54:1279.CrossRefGoogle ScholarPubMed
9.Jauregui, L, Arbulu, A, Wilson, F, Osteomyelitis, pericarditis, mediastinitis, and vasculitis due to Mycobacterium chelonei. Am Rev Respir Dis 115:699–703, 1977.Google ScholarPubMed
10.Laskowski, LF, et al: Fastidious Mycobacteria grown from porcine prosthetic heart valve cultures. N Engl J Med 1977;297:101–102.CrossRefGoogle ScholarPubMed
11.Graybill, JR, Silva, J, Fraser, DW, et al: Disseminated mycobacteriosis due to Mycobacterium abscessus in two recipients of renal homografts. Am Rev Respir Dis 1974;109:4–10.Google Scholar
12.Tsukamura, M, Nakamura, E, Kurita, I, et al: Isolation of Mycobacterium chelonei from pulmonary lesions of nine patients. Am Rev Respir Dis 1975;108:683–685.Google Scholar
13.Carson, LA, Peterson, NJ, Favero, MS, et al: Growth characteristics of atypical Mycobacteria in water and their comparative resistance to disinfectants. Appi Environ Microbiol 1978;36:839–846.CrossRefGoogle ScholarPubMed
14.Tice, A, Solomon, RJ, Disseminated Mycobacterium chelonei infection. Am Rev Respir Dis 1979;120:197–201.Google ScholarPubMed
15.Garcia-Rodriguez, JA, Martin-Luengo, F, Activity of amikacin, erythromycin and doxycycline against Mycobacterium chelonei and Mycobacterium fortuitum. Tubercle 1978;59:277–280.CrossRefGoogle ScholarPubMed
16.Sanders, WE, Hartwig, EC, Schneider, NJ, et al: Susceptibility of organisms in the Mycobacterium fortuitum complex to anti-tuberculous and other antimicrobial agents. Antimicrob Agents Chemother 1977;12:295–297.CrossRefGoogle Scholar
17.Arroyo, J, Medoff, G, Mycobacterium chelonei infection: Successful treatment based on a radio-metric susceptibility test. Antimicrob Agents Chemother 1977;11:763–764.CrossRefGoogle Scholar
18.Sutherland, GE, Lauwasser, M, McNeely, DJ, et al: Heat treatment for certain chronic granulomatous skin infections. South Med J 1980;73:1564–1565.CrossRefGoogle ScholarPubMed
19.Morris, RC, Legal aspects of nosocomial infections, in Bennett, J, Brachman, PS (eds): Hospital Infections. Little Brown & Co Inc, 1979, pp 181–194.Google Scholar
20.Borghans, JH, Stanford, JL, Mycobacterium chelonei in abscesses after injection of diphtheria-pertussis-tetanus-polio vaccine. Am Rev Respir Dis 1973;107:1–8.Google ScholarPubMed
21.Vandepitte, J, Desmyter, J, Gatti, F, Mycobacteria, skins and needles. Lancet 1969;2:691.CrossRefGoogle ScholarPubMed
22.Owen, H, Smith, A, Coultras, J, Granulomatous lesions occurring at sites of injections of vaccines and antibiotics. South Med J 1963;56:949.CrossRefGoogle Scholar
23.Canilang, B, Armstrong, D, Subcutaneous abscesses due to Mycobacterium fortuitum. Am Rev Respir Dis 1968;97:451–454.Google ScholarPubMed
24.Clapper, WE, Whitcomb, J, Mycobacterium fortuitum abscess at injection site. JAMA 1967;202:550.CrossRefGoogle ScholarPubMed