Self-inflicted bacteraemia and fungaemia in Vietnamese migrants

From early 1993, we received a number of blood cultures, all from Vietnamese inmates of the Whitehead Detention Centre, the biggest detention camp in Hong Kong, which grew unusual organisms. Upon follow-up, the majority of the patients were found to abscond from the hospital a few days after having been admitted with a clinical picture of septic shock. During the period from March 1993 to late 1994, we noted a total of 25 positive blood cultures from 21 previously healthy Vietnamese migrants with this syndrome. The mean age was 27.8 years and 20 were males. The organisms isolated from the blood cultures were of low pathogenicity such as Saccharomyces cerevisiae, Trichosporon spp., Bacillus spp, and Micrococcus spp. Fourteen of the patients complained of abdominal pain and 3 others had apical pneumothoraces. Eighteen had shock requiring resuscitation. Multiple puncture or needle marks were found in 11 patients, mainly involving the lower limbs. One patient admitted inducing illness by self-injection, and it was suspected that all these infections were self-inflicted. The range of hospitalization was 1-13 days (mean 3.05 days). Eighteen of the 21 patients absconded.