Accidental human injection of Excenel RTU: ceftiofur hydrochloride in cottonseed oil.
BACKGROUND
There is little knowledge within the medical community of the existence of veterinary antibiotics in oil-based suspensions and the adverse effects that may occur with accidental human injection.


METHODS
A farmer injected an unknown quantity of Excenel RTU into her right thigh. Despite early debridement she developed a deep infection and recurrent chronic inflammation in the subcutaneous tissues and muscle secondary to the cottonseed oil suspension. Radical debridement and extensive split skin grafting was required but she still has had recurrences 12 months after injury.


CONCLUSIONS
Prompt surgical debridement should be performed as in cases of oil based veterinary vaccines. Despite being an antibiotic there is a significant risk of infection from a dirty needle following inoculation and multiple cultures should be taken and appropriate broad spectrum antibiotics used. Radical debridement and skin grafting necessitating specialist plastic surgical attention may be required.
Gwynne-Jones
David
D
Dunedin Hospital, Orthopaedics, and Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. david.gwynne-jones@stonebow.otago.ac.nz
Lyall
Patrick
P
Hung
Noelyn A
NA
Meikle
Grant
G
D000328:Adult; D000822:Animal Husbandry; D002511:Cephalosporins / Q000009:adverse effects*; D003369:Cottonseed Oil / Q000009:adverse effects*; D003646:Debridement / Q000379:methods; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology; D007249:Inflammation / Q000139:chemically induced; D016602:Needlestick Injuries / Q000150:complications*; D009784:Occupational Diseases / Q000209:etiology; D012008:Recurrence; D016038:Skin Transplantation / Q000379:methods; D014730:Veterinary Medicine
D002511:Cephalosporins; D003369:Cottonseed Oil; C053503:ceftiofur