Mundinger Gerhard S, Douglas Keith C, Higgins James P
Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, Maryland 21218, USA.
J Hand Surg Am. 2013 Feb;38(2):362-5. doi: 10.1016/j.jhsa.2012.11.011. Epub 2013 Jan 5.
Solutions containing bacillus Calmette-Guérin (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.
含有卡介苗（BCG）的溶液，即牛分枝杆菌或结核分枝杆菌的减毒活形式，通常通过膀胱内注射来治疗膀胱肿瘤。我们报告了一例医护人员急性分枝杆菌性屈肌腱鞘炎病例，该医护人员在为膀胱内给药准备卡介苗溶液时意外通过针刺接种了手指。她接受了立即手术干预，随后使用了6个月的抗分枝杆菌抗生素，治疗成功。在之前3例卡介苗溶液自我接种后手部感染的报告中，该病例具有独特性，因为急性分枝杆菌性屈肌腱鞘炎发病迅速且术中分枝杆菌培养呈阳性。针刺接种含卡介苗的溶液，尤其是刺入屈肌腱鞘，应及时进行手术清创并给予适当的抗分枝杆菌治疗。
