Cutaneous Mycobacterium massiliense infection from tattooing: a common yet under-reported and persistent epidemic hazard for dermatologists

BMJ Case Rep. 2018 Jan 12:2018:bcr2017222762. doi: 10.1136/bcr-2017-222762.

Abstract

Tattoo popularity continues to rise, with 3 in 10 Americans bearing at least one. Among tattoo complications, non-tuberculous mycobacteria (NTM) has emerged as a global public health concern. NTM infections associated with tattooing of immunocompetent individuals have occurred as sporadic cases and community outbreaks. Water sources are considered the major pathogenic reservoirs. Tattoo-related inoculation has been linked to contamination of ink, either during the manufacturing process or during dilution of black ink using non-sterile water. NTM infections have also been documented in a number of cosmetic and surgical procedures, including cutaneous surgery, Mohs micrographic surgery, mesotherapy, liposuction and laser resurfacing. NTM inoculation through exposure to contaminated water or non-sterile instruments remains a challenge for dermatologists and risk to patients. We reported a case of cutaneous Mycobacterium massiliense infection following tattoo placement. This report underscores the importance of clinicians to consider NTM infections in the differential diagnosis of procedure-related reactions.

Keywords: dermatology; healthcare improvement and patient safety; infections; skin.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Disease Outbreaks
  • Equipment Contamination*
  • Fresh Water / microbiology*
  • Humans
  • Ink*
  • Leg / pathology*
  • Male
  • Mycobacterium Infections, Nontuberculous / drug therapy
  • Mycobacterium Infections, Nontuberculous / microbiology*
  • Mycobacterium abscessus / pathogenicity*
  • Public Health
  • Skin Diseases, Bacterial / drug therapy
  • Skin Diseases, Bacterial / microbiology*
  • Tattooing / adverse effects*
  • Tattooing / standards
  • United States

Substances

  • Anti-Bacterial Agents