[Unusual healing of tendon sheath tuberculosis by intercurrent streptococcal phlegmon]

Tuberculosis of the flexor tendon sheaths in western industrial countries is rare. The author presents a case with an exceptional course and an unexpected outcome. A sixty-five year old woman suffered from tuberculosis of the flexor tendon sheath of her little finger. Appropriate tuberculostatic treatment was impossible due to damage of liver cells by chronic hepatitis. An open wound with positive cultures of mycobacterium tuberculosis persisted over eight months despite local and systemic treatment. It was only after an incidental streptococcal infection of the wound--resembling an erysipelas--that the tuberculous germs disappeared. The result was rapid healing with return of limited but useful function of the hand.