RESUMO
Una bacterióloga sufrió un accidente por punción con una aguja con jeringa que contenía una cepa de Mycobacterium tuberculosis en un dedo de la mano. La zona de la punción se inflamó y la expresión del dedo 15 días después del accidente arrojó una gota de pus que puesta al microscopio permitió observar 3 bacilos ácido-alcohol resistentes con la técnica de Ziehl-Neelsen. Se diagnosticó tuberculosis por inoculación accidental y fue tratada como tal. Se discuten las características de este caso encuadrado como tuberculosis cutánea, cuando se produce como infección exógena por inoculación directa. (AU)
A bacteriologist suffered a puncture accident while manipulating a Mycobacterium tuberculosis strain, affecting a finger. The involved area swelled and a drop of pus came out after pressure on the finger 15 days afterwards. This was stained by Ziehl-Neelsen technique, and three acid-fast bacilli were observed. Tuberculosis was diagnosed, and proper treatment was started. We discuss the case, classified as cutaneous tuberculosis produced by exogenous infection through accidental direct inoculation. (AU)
Assuntos
Humanos , Adulto , Feminino , Infecção Laboratorial/etiologia , Tuberculose Cutânea/etiologia , Agulhas , Infecção Laboratorial/tratamento farmacológico , Teste Tuberculínico , Punções , Tuberculose Cutânea/tratamento farmacológicoRESUMO
Una bacterióloga sufrió un accidente por punción con una aguja con jeringa que contenía una cepa de Mycobacterium tuberculosis en un dedo de la mano. La zona de la punción se inflamó y la expresión del dedo 15 días después del accidente arrojó una gota de pus que puesta al microscopio permitió observar 3 bacilos ácido-alcohol resistentes con la técnica de Ziehl-Neelsen. Se diagnosticó tuberculosis por inoculación accidental y fue tratada como tal. Se discuten las características de este caso encuadrado como tuberculosis cutánea, cuando se produce como infección exógena por inoculación directa.
A bacteriologist suffered a puncture accident while manipulating a Mycobacterium tuberculosis strain, affecting a finger. The involved area swelled and a drop of pus came out after pressure on the finger 15 days afterwards. This was stained by Ziehl-Neelsen technique, and three acid-fast bacilli were observed. Tuberculosis was diagnosed, and proper treatment was started. We discuss the case, classified as cutaneous tuberculosis produced by exogenous infection through accidental direct inoculation.
Assuntos
Humanos , Adulto , Feminino , Infecção Laboratorial/etiologia , Tuberculose Cutânea/etiologia , Infecção Laboratorial/tratamento farmacológico , Agulhas , Punções , Teste Tuberculínico , Tuberculose Cutânea/tratamento farmacológicoRESUMO
A 30 year-old female laboratory technician under immunosuppressive treatment because of systemic lupus erythematosus (SLE) developed cutaneous leishmaniasis 8 months after accidental percutaneous inoculation of amastigote culture forms of Leishmania mexicana. Leishmania-specific PCR and restriction analysis patterns were identical for both the laboratory strain and the clinical specimen. The lesion was resistant to local paromomycin and oral ketoconazole, but responded to local application of meglumine antimonate. No signs of dissemination or visceralization occurred during the 5-month period of observation. However, a future recurrence cannot be excluded since a persistent infection even after clinical cure has always to be considered in leishmaniasis. Patients under immunosuppressive therapy are possibly at risk of clinical relapse or disseminating infection although there is no experience with regard to leishmaniasis mexicana. Serious infection may require interferon gamma as part of the treatment which may contribute to deterioration of concomitant diseases like SLE. In any case, the exposure of immunodeficient laboratory workers to Leishmania spp. should be avoided.