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 Mycobacterium Infections and Foot Spas
From: S.D. Emergency Medical Alert Network
Dermatologists in San Diego County have recently contacted Community
Epidemiology about patients with mycobacterium soft tissue infections
of the lower legs following use of whirlpool foot spas at local nail
salons. A recent outbreak investigation of mycobacterium infections
in northern California linked cases to prior use of whirlpool foot
spas. Accumulated debris of hair, skin, and nails trapped behind
footbath inlet screens, combined with improper maintenance, cleaning
and disinfection of the whirlpool units, promote bacterial growth and
can present a risk to users.
Atypical mycobacterium infections should be suspected in patients
(especially women) with persistent boils on the lower legs and recent
exposure to whirlpool footbaths. Culture and sensitivity testing is
necessary for specific identification and appropriate treatment.
Individuals who suspect their infections resulted from use of
whirlpool footbaths are encouraged to contact the Board of Barbering
& Cosmetology. Their website is www.barbercosmo.ca.gov/complaint.htm.
Cutaneous Leishmaniasis
Cases of cutaneous leishmaniasis (CL), a vector-borne parasitic
disease, continue to occur among United States military personnel
following exposure to infected sand flies in endemic areas. From
August 2002 to February 2004, a total of 522 parasitologically
confirmed cases of CL were identified in military personnel deployed
to Afghanistan, Iraq and Kuwait.
Healthcare providers should consider the possibility of CL in persons
with chronic skin ulcers who were deployed to Southwest/Central Asia
or who were in other areas where leishmaniasis is endemic. Civilians
who lived in or traveled to these areas are also at risk. Suspected
and diagnosed cases of CL among civilians should be reported to
Community Epidemiology.
Cutaneous leishmaniasis is characterized by single or multiple skin
lesions that typically progress from papules to nodules to ulcerative
lesions, but can persist as nodules or plaques. The incubation period
ranges from one week to several months. The diagnosis is usually made
by sampling the skin lesion with a biopsy or scraping. The drug of
choice for CL is the investigational new drug, sodium stibogluconate
(Pentostam®).
For treatment of civilians, healthcare providers should contact the
Drug Service at the Centers for Disease Control and Prevention at
404-639-3670; diagnostic services are also available. For further
information about CL, please visit:
www.cdc.gov/ncidod/dpd/parasites/leishmania/default.htm.
Thank you for your continued participation.
Emergency Medical Alert Network (EMAN)
County of San Diego, Health & Human Services Agency
Community Epidemiology Division
Phone - (619) 515-6620
Fax - (619) 515-6644
Urgent Phone for pm/weekends/holidays - (858) 565-5255
E-mail - eman@sdcounty.ca.gov
Website - www.emansandiego.com
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