Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
Insulin injections have been associated with non-tuberculous mycobacteria cutaneous infections and cutaneous mycobacteria may have a prolonged incubation period, according to a literature review and case study published in the April issue of Clinical Diabetes.
L.S., a 47-year-old white woman with type 1 diabetes, a bleeding diathesis, and iron deficiency anemia, was referred to an infectious diseases physician for assessment of a painful, nonhealing skin lesion. Before the referral, her primary care physician had treated her with several courses of oral antibiotics, including cephalexin, clindamycin, and amoxicillin, without improvement. She denied a history of preceding trauma, recent foreign travel, or exposure to aquatic animals or hot tubs. When questioned about whether the lesion was at the site of insulin injection, she stated this was possible because she had injected insulin at various locations through her clothes since adolescence, as instructed.
On physical examination, the patient appeared well. Her skin examination was significant for a 5-cm erythematous, tender nodule on the anteromedial aspect of her right thigh (Figure 1). No drainage from the lesion or evidence of surrounding cellulitis was found. There was no associated lymphadenopathy, and the remainder of her physical examination was unremarkable.
http://clinical.diabetesjournals.org/content/31/2/76.full
L.S., a 47-year-old white woman with type 1 diabetes, a bleeding diathesis, and iron deficiency anemia, was referred to an infectious diseases physician for assessment of a painful, nonhealing skin lesion. Before the referral, her primary care physician had treated her with several courses of oral antibiotics, including cephalexin, clindamycin, and amoxicillin, without improvement. She denied a history of preceding trauma, recent foreign travel, or exposure to aquatic animals or hot tubs. When questioned about whether the lesion was at the site of insulin injection, she stated this was possible because she had injected insulin at various locations through her clothes since adolescence, as instructed.
On physical examination, the patient appeared well. Her skin examination was significant for a 5-cm erythematous, tender nodule on the anteromedial aspect of her right thigh (Figure 1). No drainage from the lesion or evidence of surrounding cellulitis was found. There was no associated lymphadenopathy, and the remainder of her physical examination was unremarkable.
http://clinical.diabetesjournals.org/content/31/2/76.full