Primary Multidrug-resistant Tuberculosis in a Surgeon Secondary to a Needlestick Injury: A Neglected Problem

Overview

Journal Infect Drug Resist

Publisher Dove Medical Press

Date 2022 Nov 21

PMID 36406864

Authors

Meifang Yang

Min Xu

Xuan Zhang

Hong Zhao

Jianhua Hu

Jie Wang

Affiliations

Soon will be listed here.

Abstract

Healthcare workers (HCWs) are highly at risk for tuberculosis (TB) exposure, particularly those in high TB burden countries. Inoculation TB secondary to needlestick injury is uncommon but can occur in HCWs. Herein, we report an unusual case of primary multidrug-resistant tuberculosis (MDR-TB) in a surgeon secondary to a needlestick injury while performing thoracentesis on a TB patient, and the surgeon recovered and returned to work after 22 months of anti-TB treatment. We searched the PubMed database and identified 19 cases of inoculation TB secondary to sharp injury in HCWs including the present case. Those cases highlight that primary inoculation of TB even MDR-TB infection should not be neglected in patients suffered needlestick injury when the sharp instrument suspected or confirmed contaminated with TB. In this situation, if the HCWs need for additional protection or prophylactic anti-TB is worthy of further study.

References

Kim J, Kim T, Kim D, Yoon M . Three cases of primary inoculation tuberculosis as a result of illegal acupuncture. Ann Dermatol. 2010; 22(3):341-5. PMC: 2917693. DOI: 10.5021/ad.2010.22.3.341. View

Karoney M, Kaumbuki E, Koech M, Lelei L . Primary cutaneous tuberculosis in a 27-year-old medical intern from needle-stick injury: a case report. Clin Case Rep. 2015; 3(1):39-42. PMC: 4317210. DOI: 10.1002/ccr3.143. View

Harris S, Khan R, Verma A, Ahmad S . Finger ulceration in a healthcare professional. Ann Afr Med. 2010; 9(1):45-7. DOI: 10.4103/1596-3519.62626. View

Pang Y, An J, Shu W, Huo F, Chu N, Gao M . Epidemiology of Extrapulmonary Tuberculosis among Inpatients, China, 2008-2017. Emerg Infect Dis. 2019; 25(3):457-464. PMC: 6390737. DOI: 10.3201/eid2503.180572. View

Liu Y, Pan J, Jin K, Liu C, Wang J, Chen L . Analysis of 30 patients with acupuncture-induced primary inoculation tuberculosis. PLoS One. 2014; 9(6):e100377. PMC: 4069069. DOI: 10.1371/journal.pone.0100377. View

Huang D, Yin H . Primary inoculation tuberculosis after an accidental scalpel injury. Infection. 2013; 41(4):841-4. DOI: 10.1007/s15010-013-0442-y. View

Tapias L, Tapias-Vargas L, Tapias-Vargas L . Primary cutaneous inoculation tuberculosis in a healthcare worker as a result of a surgical accident. Int J Dermatol. 2008; 47(8):833-5. DOI: 10.1111/j.1365-4632.2008.03656.x. View

Hooker R, Eberts T, Strickland J . Primary inoculation tuberculosis. J Hand Surg Am. 1979; 4(3):270-3. DOI: 10.1016/s0363-5023(79)80162-8. View

Soto-Febres F, Ballena-Lopez J, Alva D, Riboty A, Leon R, Chang J . Cutaneous inoculation tuberculosis in a healthcare worker: Case report and literature review. IDCases. 2020; 20:e00788. PMC: 7225731. DOI: 10.1016/j.idcr.2020.e00788. View

10.

Wong H, Tay Y, Sim C . Papular eruption on a tattoo: a case of primary inoculation tuberculosis. Australas J Dermatol. 2005; 46(2):84-7. DOI: 10.1111/j.1440-0960.2005.00147.x. View

11.

Chandramukhi A, Manjunath M, Veenakumari H, Mahadevan A, Shivaraja G, Buggi S . Tuberculous skin ulcer following needle-prick injury in a health care professional. J Assoc Physicians India. 2005; 53:825-6. View

12.

Wang J, Zhu M, Li C, Zhang H, Zuo G, Wang M . Outbreak of primary inoculation tuberculosis in an acupuncture clinic in southeastern China. Epidemiol Infect. 2014; 143(5):943-8. PMC: 9507137. DOI: 10.1017/S0950268814002039. View

13.

Fnini S, Ouarab M, Rafai M, Cohen D, Largab A, Trafeh M . [An uncommon occupational accident: tuberculous tenosynovitis of the extensor tendons of the hand]. Chir Main. 2000; 18(4):309-12. View

14.

Malek A, Fife C, Rasmussen J, Karni R, Morrow J, Wanger A . Lymphatic Dissemination and Axillary Web Syndrome in Primary Cutaneous Tuberculosis Secondary to Needlestick Injury. Open Forum Infect Dis. 2021; 8(7):ofab160. PMC: 8312518. DOI: 10.1093/ofid/ofab160. View

15.

Kramer F, Sasse S, Simms J, LEEDOM J . Primary cutaneous tuberculosis after a needlestick injury from a patient with AIDS and undiagnosed tuberculosis. Ann Intern Med. 1993; 119(7 Pt 1):594-5. DOI: 10.7326/0003-4819-119-7_part_1-199310010-00007. View

16.

Sahn S, Pierson D . Primary cutaneous inoculation drug-resistant tuberculosis. Am J Med. 1974; 57(4):676-8. DOI: 10.1016/0002-9343(74)90023-0. View

17.

Delli Carri R, Piscozzi P, Massimelli M, Falcetta R . [A rare case of tubercular tenosynovitis in hospital surgeon as a result of an occupational accident caused by puncture with an infected needle. Prevention aspects and legal-medical evaluation]. Med Lav. 2010; 101(1):26-9. View

18.

Guo H, Zhong Q, Zhou J, Zhao Z, Zhang X, Chen Z . Risk of prevalence of latent tuberculosis infection in health care workers-an idiographic meta-analysis from a Chinese perspective. J Thorac Dis. 2021; 13(4):2378-2392. PMC: 8107561. DOI: 10.21037/jtd-20-1612. View

19.

Genne D, Siegrist H . Tuberculosis of the thumb following a needlestick injury. Clin Infect Dis. 1998; 26(1):210-1. DOI: 10.1086/517023. View

20.

Wang X, He T, Geng M, Song Y, Wang J, Liu M . Prevalence of and risk factors for tuberculosis among healthcare workers in Chinese tuberculosis facilities. Infect Dis Poverty. 2018; 7(1):26. PMC: 5872547. DOI: 10.1186/s40249-018-0407-6. View