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Primary Cutaneous Tuberculosis after a Needlestick Injury from a Patient with AIDS and Undiagnosed Tuberculosis
- Francoise Kramer, MD;
- Scott A. Sasse, MD;
- Janet C. Simms, RN; and
- John M. Leedom, MD
- From the Los Angeles County/University of Southern California Medical Center, Los Angeles, California. Requests for Reprints: Francoise Kramer, MD, LAC/USC Medical Center, Section of Infectious Diseases, Room 6442, 1200 North State Street, Los Angeles, CA 90033.
Case Report
A 48-year-old, white registered nurse, who was previously healthy, reported suffering a 1-cm superficial laceration of her left forearm. The laceration resulted from a metallic needle, which had previously been inserted into the port of a central-line catheter of a patient with the acquired immunodeficiency syndrome (AIDS). The lesion oozed a few drops of blood and was immediately washed with water and an iodine solution. Zidovudine (Retrovir, Burroughs Wellcome Co., Research Triangle Park, North Carolina) administration was started within 2 hours of the incident and was continued at a dose of 200 mg every 4 hours. The nurse denied direct contact with the patient's secretions before the injury and did not provide nursing care for this particular patient after her injury. She tested negative for human immunodeficiency virus (HIV) antibody on that same day.
The patient with AIDS was supported by a ventilator at the time of the incident. His respiratory failure had been attributed to a severe episode of Pneumocystis carinii pneumonia for which he was receiving therapy. A sputum smear obtained on the day of the nurse's laceration was positive for acid-fast bacilli and subsequently grew 2+ (10 to 100 colonies) of Mycobacterium tuberculosis on culture. A …
