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Workplace Medical Mystery: Drum Maker Develops a Suspicious Rash

Posted on by Stephanie Stevens, MA

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He thought it was an insect bite.

Ousmane immigrated to the United States from West Africa when he was just 20. Now living in Washington, DC, he has a thriving business making and repairing traditional West African drums as well as teaching workshops and playing around the city with his performance troupe or with friends in drum circles.

As a young boy living in Guinea, Ousmane learned how to make drums from his father, a skill he hoped to pass on to his son someday. The drums Ousmane makes, djembe drums, are carved from hardwood and the drumhead is made from animal hides that are air-dried until they are brittle enough to crack.

Ousmane typically travelled to New York City to buy goat hides from importers. However, he recently returned from a 3-week trip to Guinea where he attended a relative’s wedding. While abroad, he purchased two hard-dried goat hides and brought them back to the U.S. wrapped in a plastic bag.

After returning from his trip, Ousmane went to work crafting two new drums in his basement workshop. To make the drumheads, he soaked the new hides he purchased in Africa for 1 hour in water, stretched them over the drum body, then scraped and sanded hair from the hides with a razor. It was an unusually hot and muggy June day in Washington, DC so Ousmane wore only a short sleeve shirt and no gloves or eye protection. While sanding the drums, he felt a sting on his left forearm. Thinking nothing of it, he proceeded to finish sanding and then sweep up the hair and dust from the floor before calling it a day. He then went upstairs to wash the dust off his hands and arms.

Two days later, Ousmane noticed an itchy bump on his left forearm. Later, the little bump turned into a bigger blister and the area around the sore became red and swollen. Ousmane decided to go see his doctor in case he had an infection.

Remembering the sting he felt, Ousmane told the doctor he might have been bitten by an insect or cut himself a few days earlier while in his basement. The doctor confirmed Ousmane’s suspicion and said that it was probably a spider bite that had become infected. Ousmane’s doctor prescribed an antibiotic for 7 days to stop the infection.

After taking all his medicine, the sore had still not gone away. In fact, it got bigger and the center of it turned black. Ousmane noticed his lymph nodes were swollen and that he was also running a temperature.

What could be causing Ousmane’s symptoms? Share your ideas in the comments and stay tuned for the next installment on Friday.

Stephanie Stevens, MA, is a Health Communication Specialist in the NIOSH Office of the Director.

This blog is part of the NIOSH Workplace Medical Mystery Series. The names and certain personal details of the characters are fictitious and do not represent an actual person or persons.

Posted on by Stephanie Stevens, MA

21 comments on “Workplace Medical Mystery: Drum Maker Develops a Suspicious Rash”

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    My first suspicion is cutaneous anthrax. It is common in some areas and easily acquired. Sick animals would be likely source for animal hides.
    From the Mayo clinic:
    Cutaneous anthrax

    A cutaneous anthrax infection enters your body through a cut or other sore on your skin. It’s by far the most common route the disease takes. It’s also the mildest — with appropriate treatment, cutaneous anthrax is seldom fatal. Signs and symptoms of cutaneous anthrax include:
    •A raised, itchy bump resembling an insect bite that quickly develops into a painless sore with a black center
    •Swelling in the sore and nearby lymph glands

    I think the drum maker may have the beginning of Anthrax infection. I believe people who work with leather/hides in this manner are at risk.

    i think ousmane was bite by Brown Recluse Spider.
    this spider causes series infection in victim’s flash.

    He could have been bitten by a spider which often causes a continued sore…brown recluse, which can cause an immune response with lymph node enlargement Bites from brown recluse take a long time to heal and can cause tissue to die often needing debridment.

    Interesting article. I would think that with anthrax the antibiotics would have kept it the wound from growing. The spider bite may be more to the point as the drum maker had noted there was a sting and the fact that the wound has kept growing. The African version of the Brown Recluse is Violin Spider.

    In my opinion that was Anthrax or bite by Brown Recluse spider, but he took antibiotics so if that was Anthrax, the wound shouldn’t have grown…

    Best regards,

    He probable contracted cutaneous anthrax but did he not also, by smuggling into the USA two hard-dried goat hides did he not, violate US Fish and Wildlife regulations.

    Animal hides that have been tanned or pickled (soaked in a salt solution) are considered to be less likely to spread infectious diseases like anthrax, and may be imported under certain conditions. Animal hides are not allowed to enter the United States if they have not been treated to make them less likely to spread disease.
    Treating animal hides can help reduce the risk of getting anthrax when handling them, but there is no way to completely get rid of anthrax spores on drums. No tests are available to determine if animal products are free from contamination with anthrax spores.
    The United States Department of Agriculture (USDA) regulates the importation of animal products, including processed and unprocessed cattle and goat hides. For more information about rules for importing animal products, visit the USDA Animal and Plant Health Inspection Service website.

    Ousmane’s occupation, region where he bought the goat hides, his inhalation and skin exposure, as well as his symptoms, all support an anthrax disease scenario.

    F. Tularensis ulceroglandular form
    B. Anthracis as wool sorter diseas
    Still other shoul be considered, I would call local epidemiological/DOH type place in Africa to find endemic goat’s diseases

    Cutaneous anthrax? This is a big problem in Poland! It is difficult to find the right solution.
    Best regards, Marcin, Poland

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