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Eikenella corrodens in human bite infections of the hand
Abstract:
Over a 51/2-year period 30 patients were found with Eikenella corrodens infections of the hand following closed fist injury. Twenty-four had mixed infections; six grew pure cultures of Eikenella. Twenty-one of the 30 patients had positive cultures from an injured metacarpophalangeal joint. A delay in presentation or an inaccurate initial diagnosis appeared to be the most significant factors leading to the complications of osteomyelitis (in five patients) and significant loss of joint function (in eight other patients). Clinicians must have a high index of suspicion when evaluating any hand injury and clenched fist injuries of the hand should be treated by early adequate surgical debridement followed by IV penicillin given until operative cultures confirm or deny contamination with Eikenella corrodens.
Insights
Eikenella corrodens hand infections often follow clenched fist injuries. Early surgical debridement and IV penicillin are crucial to prevent complications like osteomyelitis and joint dysfunction.
Area of Science:
- Orthopedics
- Infectious Diseases
- Hand Surgery
Background:
- Eikenella corrodens is a common cause of infection following hand injuries.
- Clenched fist injuries, particularly those involving the metacarpophalangeal joint, are at high risk.
Purpose of the Study:
- To investigate the incidence and outcomes of Eikenella corrodens infections in hand injuries.
- To identify factors contributing to complications and recommend optimal treatment strategies.
Main Methods:
- Retrospective review of 30 patients with Eikenella corrodens hand infections over 5.5 years.
- Analysis of infection types (pure vs. mixed), joint involvement, and patient outcomes.
Main Results:
- Eikenella corrodens was identified in 30 hand infections post-clenched fist injury.
- Twenty-one infections involved the metacarpophalangeal joint; five developed osteomyelitis, and eight had significant joint function loss.
Conclusions:
- Delayed presentation and misdiagnosis are key factors in complications.
- Early surgical debridement and IV penicillin are recommended for suspected Eikenella corrodens hand infections.