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QJM Advance Access originally published online on September 23, 2009
QJM 2009 102(12):881-884; doi:10.1093/qjmed/hcp129
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© The Author 2009. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Extensive cutaneous Mycobacterium abscessus infection due to contaminated insulin delivery system

T.R. Bates1,2, T. Keenher3, L.C. O’Reilly3, C.H. Heath4, J.P. Flexman4 and R.J. Murray3,4

From the 1Department of Internal Medicine, Royal Perth Hospital, Western Australia, 2School of Medicine and Pharmacology, University of Western Australia, 3Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine WA, Queen Elizabeth II Medical Centre and 4Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine WA, Royal Perth Hospital, Western Australia

Address correspondence to Dr Ronan Murray, Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine WA, Queen Elizabeth II Medical Centre, Hospital Avenue, Nedlands, WA 6009, Australia. email: ronan.murray@health.wa.gov.au

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   Case report
 
A 48-year-old insulin-dependent diabetic woman presented with multiple lesions at her insulin injection sites. The lesions had gradually appeared and progressively enlarged over a 7-week period. Her background included 27 years of insulin-dependent diabetes mellitus, complicated by micro-vascular disease with early diabetic nephropathy, sensory peripheral polyneuropathy and grade 1 diabetic retinopathy. Diabetic management had been with a basal-bolus regimen of insulin, but with generally poor diabetic control (glycosylated haemoglobin of 10–11%). The lesions were only associated with her isophane insulin (delivered by a NovojetTM pen system) injection sites; her abdominal neutral insulin (ActrapidTM) injection sites were unaffected. She . . . [Full Text of this Article]


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