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A 27-year-old medical intern contracted a rare tuberculosis strand from a needle prick on the little finger at a local referral hospital as he was attending to an HIV-infected patient.
A study published in the journal Clinical Case Reports by doctors at the hospital, Moi University and the Ministry of Health revealed how the intern spent almost a year undergoing incorrect treatments.
"He sustained a small cut that bled a little and he immediately washed it with water and soap," says the study which was led by Mercy Jelagat of the Moi University Clinical Research Centre.
He was immediately put on a 28-day HIV preventive treatment with anti-retroviral after which he was confirmed negative.
However, within two weeks after the injury, the little finger had started swelling and was accompanied by a persistent dull pain for which he sought surgical intervention.
A small surgical procedure was carried out to clean and drain the infected area and he was treated for other possible infections.
"His little finger now had an open wound that persisted for several months despite repeated medical cleaning and generous prescription of various types of antibiotics," the report revealed.
The study shows the HIV positive female patient was being investigated for meningitis and died soon after but her results were not followed up until several months later.
For next six month, the finger would continue to swell, even spreading to the rest of the hand
"This was accompanied by fever, night sweats, and weight loss and at this point he underwent another surgery and was put on further medication," the report showed.
Harvested tissue
During this period he underwent a whole battery of medical tests including radiology, blood counts, for liver and renal functions but he was still not responding to treatment.
Ten months later and with no improvement he underwent yet another surgical procedure and this time around harvested tissue from the wound indicated the presence of the tuberculosis causing bacteria.
He was put under TB treatment for six months at the end of which he had fully recovered and was confirmed to be both TB and HIV negative.
While all seemed to have ended well for the intern, the four-man team is now advising that though skin TB is rare, "It should be suspected in all patients who present with skin cuts that do not respond to antibacterial treatment and may very likely infect health workers".
In May the Journal of Acquired Immune Deficiency Syndromes, quoting the Kenya Aids Indicator Survey said a significant number of Kenyans are getting HIV infections from medical injections.
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