Fast Five Quiz: Tattoos

Brett Sloan, MD


September 10, 2020

Although infection secondary to tattoos is currently unusual, infection may be introduced into the skin during the breach of the epidermal barrier. Bacterial infections may be limited but sometimes result in true erysipelas, gangrene, or systemic sepsis. The infections can range in severity from a mild, localized infection to bacterial sepsis. Superficial infections (eg, impetigo), deep bacterial infections that present as cellulitis or erysipelas, and systemic infections have all been reported.

Bacteremia or acute pyogenic skin infections typically occur within a few days of tattooing. They most often involve S aureus, Streptococcus species, and Pseudomonas aeruginosa. A rare case of cutaneous diphtheria caused by C diphtheriae was reported in New Zealand; however, S aureus may have been the primary pathogen. A report from Scotland detailed 71 confirmed and 71 probable tattoo-related infections with nontuberculous mycobacterial skin infections, including Mycobacterium chelonae, Mycobacterium haemophilum, and Mycobacterium abscessus. Infective endocarditis was reportedly associated with five separate tattoo infections; S aureus was the etiologic agent found in several cases, with Staphylococcus lugdunensis and M lacunata responsible in others.

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