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Updated: Feb 15, 2026
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Murine Flexor Tendon Injury and Repair Surgery
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A Rare Cause of Pyogenic Flexor Tenosynovitis: Nocardia nova
Andrew Wilhelm1, Nicholas Romeo2, Richard Trevino3
1The Orthopaedic Residency of York, York, PA.
The Journal of Hand Surgery
|January 21, 2018
Summary
A rare Nocardia nova infection caused severe complications, including pyogenic flexor tenosynovitis and carpal tunnel syndrome, after a thumb trigger finger release in a cactus farmer.
Area of Science:
- Hand surgery
- Infectious diseases
- Microbiology
Background:
- Open trigger digit release is a common surgical procedure.
- Infection is a known complication, occurring in about 5% of cases.
- Infections can be superficial or deep, affecting surgical outcomes.
Observation:
- A cactus farmer developed symptoms after an uneventful thumb trigger finger release.
- The patient presented with pyogenic flexor tenosynovitis and acute carpal tunnel syndrome.
- Diagnosis revealed infection by Nocardia nova.
Findings:
- Nocardia nova infection led to severe post-operative complications.
- Flexor tenosynovitis and carpal tunnel syndrome were direct results of the infection.
- This case highlights an unusual presentation of Nocardia nova in hand surgery.
Implications:
- Awareness of Nocardia nova as a potential pathogen in hand infections is crucial.
- Prompt diagnosis and appropriate antibiotic treatment are essential for managing such infections.
- This case underscores the importance of considering atypical organisms in post-operative infections.
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