Reactions 1680, p309 - 2 Dec 2017 Infections and pain: 2 case reports Two patients were reported (44-year-old woman and 42-year-old man), who developed pain and infections following sodium thiosulfate injections. Case 1: A 44-year-old woman developed tumoral calcinosis (TC) of right elbow and forearm and the two ischiatic regions. In spite of treatment with various drugs, TC progressed. Therefore, she started to receive intra-lesional injections of sodium thiosulfate weekly [dose not stated], in November 2015. During the sessions, multiple injections were administered around TC. The total volume ranged from 1-3g, depending upon her tolerance. The first session was painful. Therefore, for subsequent sessions, she was premedicated with painkillers and local lidocaine anaesthesia patch was used. During the fifth month of treatment, 48 hours after the injection, she developed a subcutaneous infection. She was successfully treated with anti-staphycoccal antibiotics [specific drugs not stated]. Case 2: A 42-year-old man had familial hyperphosphatemic TC on the right side of the left tibia and another lesion in the right buttock. He was receiving topical sodium thiosulfate for the tibial lesion, which nearly disappeared. However, the topical treatment was not efficient for the buttock lesion. Therefore, he was given multiple local injections of sodium thiosulfate around the pseudocyst, weekly [dose not stated]. He experienced pain during the injections; therefore, lidocaine patches were used before the injections. The frequency of injections was reduced to two weeks a month and then stopped from month 10 to month 15, due to injection- associated pain. During the 21 months of treatment, he developed two infections [duration of treatment to reactions onset not stated]. The causative organism was found to be Streptococcus agalactiae, and the infections were controlled effectively by appropriate antibiotics [specific drugs not stated]. Author comment: "We observed no side effects, except a subcutaneous infection occurring 48h after an injection during the fifth month." "The first session of injections was painful." "Injections were preceded by application of lidocaine patches to limit injection-related pain. "However, the local reaction induced by [sodium thiosulfate] could favour a local bacterial graft and therefore infection." Goossens J, et al. Efficacy of intralesional sodium thiosulfate injections for disabling tumoral calcinosis: Two cases. Seminars in Arthritis and Rheumatism 47: 451-455, No. 3, Dec 2017. Available from: URL: http://doi.org/10.1016/ j.semarthrit.2017.05.013c - France 803285575 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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