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Once bitten, twice shy

BMJ 1994; 309 doi: (Published 24 December 1994) Cite this as: BMJ 1994;309:1694
  1. J Marshall, senior house officer, medicinea,
  2. E Sharp, surgical registrara,
  3. I G Barrison, consultant physiciana
  1. a Departments of Medicine and Surgery, Hemel Hempstead General Hospital, Hemel Hempstead, HP2 4AD
  1. Correspondence to: Dr Barrison.

    Confronted by the recurrence of abscesses without any relevant medical history, we could only treat the patient with drainage and antibiotics. The cause of the problem turned out to be rather unexpected.

    Case report

    A 24 year old woman presented with fever and an abscess in her left antecubital fossa. She claimed that three weeks previously she had attended a blood donor session and an attempted cannulation at the site of the abscess had been unsuccessful. General examination was otherwise unremarkable and the only admitted history was of tonsillectomy, appendicectomy, and extraction of wisdom teeth. Incision and drainage of the abscess in the left antecubital fossa was undertaken on the night of admission and a ß haemolytic streptococcus and Escherichia coli were grown from the pus evacuated.

    Her fever settled with intravenous antibiotics, but four days after admission a further abscess appeared on the dorsum of the right foot. Further …

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