eTable. Reported cases of tattoo-related, non-mycobacterial infections.
|
Manifestations at primary infection site (tattoo) |
Secondary infection complications, (concomitant pre-existing conditions supporting bacterial infections) |
Number of cases*, patient’s country of origin |
Age (years), sex (m/f) |
Organisms identified (Source) |
Incubation period (days) |
Likely cause of infection, transmission route |
Outcome | Reference |
| Local skin infections | ||||||||
| Skin and soft tissue infection |
1, United States of America |
45, m | MRSA (WS) |
NA | Improper sanitary conditions: sharing needles and tattoo paraphernalia at a correctional facility |
NA | Stemper et al. (2006) (17) |
|
| Abscess | 3, United States of America |
18, f | MRSA (WS, abscess drainage) |
NA | Unhygienic conditions |
Fully recovered after 8 weeks |
Coulson (2012) (22) |
|
| Abscess, tissue necrosis |
(drug detoxification) | 22, f | MRSA (WS, abscess drainage) |
NA | NA | Fully recovered after 6 weeks |
||
| Multiple abscesses, cellulitis |
37, m | MSSA, S. pyogenes (WS, abscess drainage) |
7 | Potential ink contamination |
Hospitalization, fully recovered after 4 weeks |
|||
| Cutaneous diphtheria, cellulitis |
1, New Zealand | Adult, m | Toxigenic Corynebacterium diphtheriae var. gravis, S. aureus (WS) |
within days | Traditional Samoan tattooing |
Hospitalization, fully recovered within 1 week |
Sears et al. (2012) (23), McGouran et al. (2012) (24) |
|
| Abscess | 1, Germany | 31, m | MRSA (WS, abscess drainage) |
NA | NA | NA | Wollina (2012) (25) |
|
| Abscesses | 4, France | 29–43, m | MSSA (WS) | <21 | Tattooing or body shaving with mechanical razors |
NA | Bourigault et al. (2014) (30) |
|
| Abscess | 1, Spain | 32, m | S. marcescens (WS, abscess drainage) |
30 | NA | Hospitalization, fully recovered after 15 weeks |
Diranzo-Garcia et al. (2015) (34) |
|
| Erythema, pustules | 1, Italy | 31, f | P. aeruginosa (WS) |
2 | Possible use of non-sterile tattooing technique or contamination of the ink |
Recovery after 2 weeks |
Maloberti et al. (2015) (36) |
|
| Erythema | Lyell's syndrome (staphylococcal scalded skin syndrome; SSSS) |
1, Denmark | 48, m | S. aureus (WS) | NA | Home kit tattoo ink imported via the internet, probable phototoxic reaction to the ink followed by a break in the skin barrier due to itching resulting in bacterial infection |
Hospitalization, recovery after 1 week (followed by a 6 months treatment against allergic contact dermatitis reaction) |
Mikkelsen et al. (2015) (37) |
| Systemic complications | ||||||||
| Purulent wound infection |
Septicemia | 1, Nigeria | Newborn, NA | P. aeruginosa (BC, WS, pus) |
1 | Tribal tattooing under unhygienic conditions |
Hospitalization, death |
Mathur and Sahoo (1984) (11) |
| Cellulitis and fasciitis, subcutaneous abscess |
Polymicrobial septicemia |
1, Australia | 25, m | P. aeruginosa, S. pyogenes (BC, WS), K. oxytoca, MSSA (WS), Bacteroides fragilis (abscess drainage) |
7 | Traditional Samoan tattooing under unhygienic conditions |
Hospitalization, fully recovered after 9 weeks |
Korman et al. (1997) (12) |
| Pustular lesions | Acute spinal epidural abscess with lower limb weakness |
1, United States of America |
25, f | MSSA (WS, abscess drainage) |
7 | NA | Hospitalization, fully recovered after 8 weeks |
Chowfin et al. (1999) (13) |
| Endocarditis (bicuspid aortic valve) |
1, United Kingdom | 28, m | S. aureus (BC, explanted aortic valve) |
7 | NA | Hospitalization, fully recovered after 16 weeks |
Satchithananda et al. (2001) (14) |
|
| Cellulitis | Septic shock | 2, New Zealand | 45, m | S. aureus, S. pyogenes, P. aeruginosa (WS) |
2 | Traditional Samoan tattooing under unhygienic conditions |
Hospitalization, fully recovered after 4 weeks |
Porter et al. (2005) (15) |
| Necrotizing fasciitis |
Septic shock, abdominal compartment syndrome, acute heart failure |
29, m | S. pyogenes, S. aureus (WS), Corynebacterium spp., K. oxytoca (soft tissue debridement) |
2 | Traditional Samoan tattooing, use of non-sterile equipment, highly contaminated ink and yellow pigment (aerobic spore-forming bacilli) |
Hospitalization, death | ||
| Cellulitis, pustules, abscesses |
Bacteremia (4/34 cases) (no underlying diseases except for one patient with hepatitis C) |
34, United States of America |
15–42, 73% m | MRSA (WS) |
4–22 | Use of non-sterile equipment and suboptimal infection-control practices (unlicensed tattooists) |
Hospitalization (4/34 cases) |
CDC (2006) (16) |
| Local skin infection | Endocarditis (bicuspid aortic valve) |
1, United Kingdom | 44, m | S. lugdunensis (BC) |
NA | NA | Hospitalization, full recovery |
Tse et al. (2009) (18) |
| Erythema | Xanthogranulomatous pyelonephritis |
1, United States of America | 16, m | MRSA (renal tissue) |
<21 | Unsterile tattooing |
Hospitalization, fully recovered after 4 weeks |
Chalmers et al. (2010) (20) |
| Endocarditis | 1, Argentina | 34, f | Moraxella lacunata (BC) |
4 | NA | Hospitalization, fully recovered after 8 weeks |
Callejo et al. (2010) (19) |
|
| Extensive cellulitis | Septic shock leading to acute renal failure |
2, New Zealand | 23, m | S. aureus and group C streptococci (WS) |
3 | Traditional Samoan tattooing under unhygienic conditions |
Hospitalization, full recovery after 6 weeks but ongoing wound management required |
McLean and D’Souza (2011) (21) |
| Severe cellulitis, necrotizing fasciitis |
Septic shock leading to multi-organ failure |
25, m | S. pyogenes, P. aeruginosa (WS) |
2 | Traditional Samoan tattooing under unhygienic conditions |
Hospitalization, full recovery after 6 weeks but ongoing wound management required |
||
| Deep skin infection, multiple abscesses |
Sepsis | 1, United States of America |
46, m | Group A streptococci and MSSA (BC) |
<5 | Traditional Samoan tattooing |
Hospitalization, fully recovered after 6 weeks |
Elegino-Steffens et al. (2013) (27) |
| Tropical pyomyositis | 1, Cuba | 19, f | S. aureus (WS) |
15 | Non-professional tattooing under unhygienic conditions |
Complete recovery after 4 weeks |
Báez Sarría et al. (2013) (26) |
|
| Superficial skin infection |
Iliopsoas abscess | 2, United States of America |
Adult, m | MRSA | NA | Sharing the same ink and equipment with his wife | Hospitalization | Gulati et al. (2014) (31) |
| Iliopsoas abscess (intravenous drug abuse, hepatitis C) |
48, f | MRSA (BC) |
NA | Non-professional home-made tattoo under unhygienic conditions or potential ink contamination |
Hospitalization, fully recovered |
|||
| Endocarditis (myxoid degeneration of the mitral valve), septic emboli (knee, brain, lung) |
1, United States of America |
23, m | MSSA (BC) |
1–2 | NA | Hospitalization, fully recovered after 6 weeks |
Akkus et al. (2014) (28) |
|
| Abscess | Peripheral septic thrombophlebitis; necrotizing pneumonia (intravenous drug abuse in medical history) |
1, United States of America |
28, m | MRSA (WS, abscess drainage, BC, sputum) |
7 | NA | Hospitalization, fully recovered after 6 weeks |
Rabbani and Sharma(2014) (33) |
| Sepsis, septic emboli (muscle and joints) | 1, United States of America |
18, m | Haemophilus influenzae (BC) |
14 | NA | Hospitalization, fully recovered after 2 weeks |
Kaldas et al. (2014) (29) |
|
| Sepsis, endocarditis, pulmonary emboli (open valvotomy for congenital aortic stenosis at the age of 18 months followed by Ross procedure) |
1, United Kingdom | 20, m | MSSA (BC, excised pulmonary homograft tissue) |
28 | Tattooing under unhygienic conditions |
Hospitalization, recovered after 8 weeks |
Orton et al. (2014) (32) |
|
| Erythematous rash and multiple papules |
Toxic shock syndrome |
1, South Korea | 26, m | MSSA (WS) |
3 | NA | Hospitalization, fully recovered after 2–3 weeks |
Jeong et al. (2015) (35) |