title: The effects of injection of bovine vaccine into a human digit: a case report.
abstract: BACKGROUND
  The incidence of needlestick injuries in farmers and veterinary surgeons is significant and the consequences of such an injection can be serious.
  
  
  METHODS
  We report accidental injection of bovine vaccine into the base of the little finger. This resulted in increased pressure in the flexor sheath causing signs and symptoms of ischemia. Amputation of the digit was required despite repeated surgical debridement and decompression.
  
  
  CONCLUSIONS
  There have been previous reports of injection of oil-based vaccines into the human hand resulting in granulomatous inflammation or sterile abscess and causing morbidity and tissue loss. Self-injection with veterinary vaccines is an occupational hazard for farmers and veterinary surgeons. Injection of vaccine into a closed compartment such as the human finger can have serious sequelae including loss of the injected digit. These injuries are not to be underestimated. Early debridement and irrigation of the injected area with decompression is likely to give the best outcome. Frequent review is necessary after the first procedure because repeat operations may be required.
authors.affiliation: Orthopaedic Department, Princess Royal Hospital, Lewes Road, Haywards Heath, West Sussex RH16 4EX, UK. jenniferoneill@hotmail.com
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: O'Neill
authors.forename: Simon W
authors.initials: SW
authors.lastname: Richards
authors.forename: David M
authors.initials: DM
authors.lastname: Ricketts
authors.forename: Marc H
authors.initials: MH
authors.lastname: Patterson
mesh_terms: D000062:Accidents, Occupational; D000328:Adult; D000671:Amputation, Surgical; D000822:Animal Husbandry; D000818:Animals; D001912:Bovine Virus Diarrhea-Mucosal Disease / Q000517:prevention & control; D002417:Cattle; D001908:Diarrhea Viruses, Bovine Viral / Q000187:drug effects; D005383:Finger Injuries / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D016602:Needlestick Injuries / Q000209:etiology* / Q000601:surgery; D017778:Vaccines, Combined / Q000633:toxicity*; D014765:Viral Vaccines / Q000633:toxicity*
chemical_list: D017778:Vaccines, Combined; D014765:Viral Vaccines