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Reminder of important clinical lesson
Primary inoculation skin tuberculosis by accidental needle stick
  1. Inês Belchior1,
  2. Bárbara Seabra2,
  3. Raquel Duarte2,3,4
  1. 1Department of Pulmonology, Hospital de São João, Porto, Portugal
  2. 2Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  3. 3Department of Pulmonology, Centro de Diagnóstico Pneumológico, Vila Nova de Gaia, Portugal
  4. 4Faculty of Medicine, Porto University, Porto, Portugal
  1. Correspondence to Dr Inês Belchior, inesbelchior{at}


A 42-year-old female laboratory worker presented with a left index finger skin lesion after an accidental prick while handling samples of a cultural exam of Mycobacterium tuberculosis. Surgical excision was performed and pathology analysis revealed a dermic chronic inflammatory process with no granulomas. Later, a non-painful lymphadenopathy appeared in the left axilla as well as brownish indurated skin lesions in the lower limbs consistent with erythema nodosum. Fine needle aspiration biopsy of the lymph node revealed epithelioid granulomas, Langhans’ multinucleated giant cells and the presence of acid-fast bacilli. Standard tuberculosis treatment resulted in regression of lesions and no relapses occurred in the 2-year follow-up period.

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  • Competing interests None.

  • Patient consent Obtained.