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Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
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Eosinophilic fasciitis: case report.

Andréa B Lese1, Seth D Dodds

  • 1Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, Yale-New Haven Hospital, New Haven, Connecticut..

The Journal of Hand Surgery
|November 12, 2013
PubMed
Summary
This summary is machine-generated.

Eosinophilic fasciitis can mimic serious infections like necrotizing fasciitis in children. Early diagnosis through biopsy is crucial when cultures are negative, leading to effective treatment with anti-inflammatory medication.

Keywords:
Eosinophilic fasciitis

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Area of Science:

  • Rheumatology
  • Orthopedic Surgery
  • Pediatric Infectious Diseases

Background:

  • Acute claw hand and signs of flexor tenosynovitis can present similarly to necrotizing fasciitis.
  • Infectious etiologies are often suspected in such presentations, prompting surgical intervention and antibiotic therapy.

Observation:

  • A 16-year-old male presented with acute claw hand and symptoms mimicking necrotizing fasciitis.
  • Initial treatment with incision, drainage, and antibiotics led to temporary improvement, followed by relapse.
  • Subsequent investigations, including repeat cultures and pathological examination, revealed no infectious agent.

Findings:

  • The pathological diagnosis was eosinophilic fasciitis.
  • The patient responded well to nonsteroidal anti-inflammatory medication after the second surgical intervention.
  • No further relapse occurred after completing the anti-inflammatory treatment.

Implications:

  • Eosinophilic fasciitis should be considered in the differential diagnosis of acute claw hand with findings suggestive of necrotizing fasciitis, especially when infection is not identified.
  • Biopsies during operative interventions are valuable for diagnosing conditions that mimic severe infections but lack purulence.
  • This case highlights the importance of considering non-infectious inflammatory conditions in pediatric patients presenting with acute hand deformities and signs of severe inflammation.