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Pyogenic Flexor Tenosynovitis Caused by Shewanella putrefaciens.

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Summary

Flexor tenosynovitis can be caused by marine bacteria like Shewanella putrefaciens, even without direct marine contact. Prompt surgical intervention is crucial to prevent severe complications such as tendon necrosis and amputation.

Keywords:
dip: distal interphalangealflexor tenosynovitisshewanella putrefaciens

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Area of Science:

  • Infectious Diseases
  • Surgical Emergencies
  • Microbiology

Background:

  • Flexor tenosynovitis is a critical condition requiring immediate surgical management to avert tendon necrosis and potential amputation.
  • Gram-negative bacilli, Shewanella, are typically associated with marine environments and infrequently cause human infections.

Observation:

  • A case of flexor tenosynovitis was reported involving Shewanella putrefaciens.
  • The patient sustained penetrating trauma but had no direct marine exposure.
  • The patient presented with Kanavel's four cardinal signs, necessitating surgical irrigation and debridement.

Findings:

  • Purulence was identified during surgery, but no flexor tendon necrosis was observed.
  • Shewanella putrefaciens was identified as the causative organism.

Implications:

  • This case highlights the importance of considering marine organisms in flexor tenosynovitis, irrespective of apparent marine exposure.
  • Thorough patient history, including environmental exposures, is vital for diagnosing and managing infections.
  • Early surgical intervention and appropriate antibiotic therapy are essential for favorable outcomes in suspected cases.