LETTER
Transmission of Infection by Endoscopy
Alvin Markovitz
1 September 1993 | Volume 119 Issue 5 | Pages 440-441
TO THE EDITOR:
In their review, Spach and colleagues [1] stated that after a MEDLINE search from 1966 to 1992, they reviewed 265 articles on transmission of infection with endoscopy. They missed my article in the Western Journal of Medicine, a short report of an unusual organism transmitted in an unusual way [2].
In 1974, a 20-year-old man had been in an automobile accident in Honolulu and had multiple fractures, including fractured ribs resulting in a pneumothorax. He had, among other procedures, a bronchoscopy with a rigid bronchoscope. He improved and was discharged, but 7 months after discharge, he was admitted with a pulmonary infiltration. Bronchoscopy was repeated, and a culture specimen grew Pseudomonas pseudomallei. This finding led to the diagnosis of acute melioidosis, caused by an organism usually found in Southeast Asia but not in the Hawaiian Islands. This young soldier had never been to Southeast Asia. Review of hospital records indicated that before this patient's bronchoscopy in 1974, another patient at the hospital who had contracted this infection in Southeast Asia on military service had had a bronchoscopy with the same scope.
1. Spach DH, Silverstein FE, Stamm WE. Transmission of infection by gastrointestinal endoscopy and bronchoscopy. Ann Intern Med. 1993; 118:117-28.
2. Markovitz A. Inoculation by bronchoscopy (Letter). West J Med. 1979; 131:550.
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