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December 7, 1984

Suppurative Flexor Tenosynovitis After Accidental Self-Inoculation With Streptococcus pneumoniae Type I

JAMA. 1984;252(21):3003-3004. doi:10.1001/jama.1984.03350210051029

THIS report describes the accidental self-inoculation with a strain of Streptococcus pneumoniae type I that resulted in a serious hand infection.

Report of a Case  During a routine subcutaneous inoculation of rats with S pneumoniae type I, A5 strain (received from the US Army Medical Research Institute of Infectious Diseases and thought to be attenuated), a healthy, 36-year-old, male research scientist accidentally inoculated the fifth metacarpophalangeal (MCP) joint of his left hand with a 1.0-mL tuberculin syringe with a 26-gauge×1.3-cm needle. The inoculum contained 7×104 colony-forming units per milliliter, determined by plating on sheep-blood agar. The patient was holding the syringe by the barrel and penetrated the skin over the joint without depressing the plunger. It was thought that the inoculum was small. (The number of organisms in the needle only was estimated to be less than 200.) The needle was not sterile; rats had been inoculated with the