Hand Infections

2018 ◽  
Author(s):  
Scott D Lifchez ◽  
Colton McNichols
Keyword(s):  
Differential Diagnosis ◽  
Acute Infection ◽  
Disease Process ◽  
Hand Surgery ◽  
Inpatient Setting ◽  
Timely Manner ◽  
Functional Deficit ◽  
Hand Infection ◽  
Patient Will ◽  
Flexor Tenosynovitis

Hand infections are a common concern in the emergency, outpatient, and inpatient setting. It is important to accurately diagnose and treat these infections to minimize the risk of spread or functional deficit that could be permanent if not addressed in a timely manner. In this chapter, we aim to cover the epidemiology and etiology of hand infections along with how they tend to present in the clinical setting. This chapter is written so that each encounter can be analyzed in a logical, step-wise fashion from formulating a differential diagnosis to treatment. Upon evaluation, it is important to perform a thorough clinical examination in addition to knowing which imaging modalities can help elucidate the pathology when the initial presentation is unclear. These and other diagnostic studies are covered so that the differential diagnosis can be narrowed down. Each of the possible scenarios is clarified further to help confirm the most likely diagnosis. Finally, we touch on each treatment (whether surgical or medical) recommended for the suspected disease process. Overall, it is important to discern whether the patient will need a small procedure, surgery, or medication alone so that the appropriate management is performed and optimal healing is possible. This review contains 25 Figures, 10 Tables and 26 references Key Words: acute infection, chronic infection, paronychia, felon, flexor tenosynovitis, septic joint, hand infection, hand surgery

scholarly journals Not Only a Formulation: The Effects of Pickering Emulsion on the Entomopathogenic Action of Metarhizium brunneum

2021 ◽  
Vol 7 (7) ◽  
pp. 499
Author(s):  
Nitsan Birnbaum ◽  
Victoria Reingold ◽  
Sabina Matveev ◽  
Chandrasekhar Kottakota ◽  
Michael Davidovitz ◽  
...  
Keyword(s):  
Ricinus Communis ◽  
Larval Mortality ◽  
Acute Infection ◽  
Larval Growth ◽  
Disease Process ◽  
Pickering Emulsion ◽  
Broad Host Range ◽  
High Humidity ◽  
Conventional Agriculture ◽  
Metarhizium Brunneum

Growing global population and environmental concerns necessitate the transition from chemical to eco-friendly pest management. Entomopathogenic fungi (EPF) are rising candidates for this task due to their ease of growing, broad host range and unique disease process, allowing EPF to infect hosts directly through its cuticle. However, EPF’s requirement for high humidity negates their integration into conventional agriculture. To mitigate this problem, we formulated Metarhizium brunneum conidia in an oil-in-water Pickering emulsion. Conidia in aqueous and emulsion formulations were sprayed on Ricinus communis leaves, and Spodoptera littoralis larvae were introduced under low or high humidity. The following were examined: conidial dispersion on leaf, larval mortality, conidial acquisition by larvae, effects on larval growth and feeding, and dynamic of disease progression. Emulsion was found to disperse conidia more efficiently and caused two-fold more adhesion of conidia to host cuticle. Mortality from conidia in emulsion was significantly higher than other treatments reaching 86.5% under high humidity. Emulsion was also found to significantly reduce larval growth and feeding, while conferring faster fungal growth in-host. Results suggest that a Pickering emulsion is able to improve physical interactions between the conidia and their surroundings, while weakening the host through a plethora of mechanisms, increasing the chance of an acute infection.

scholarly journals A Case Report of Herpetic Whitlow with Positive Kanavel’s Cardinal Signs: A Diagnostic and Treatment Difficulty

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Milos Brkljac ◽  
Samer Bitar ◽  
Zafar Naqui
Keyword(s):  
Differential Diagnosis ◽  
Recurrent Infection ◽  
Middle Finger ◽  
History Taking ◽  
Oral Antibiotics ◽  
Acute Viral Infection ◽  
Diagnostic Confusion ◽  
Simplex Virus ◽  
Flexor Tenosynovitis ◽  
Herpetic Whitlow

Herpetic whitlow is an acute viral infection of the hand caused by either herpes simplex virus (HSV) 1 or 2. Its characteristic findings are significant pain and erythema with overlying nonpurulent vesicles. The differential diagnosis includes flexor tenosynovitis. We present a case of recurrent infection of the middle finger in an immunocompetent 19-year-old girl. Multiple painful pustules with tracking cellulitis were partially treated by oral antibiotics. A recurrence with positive Kanavel’s signs suggested flexor tenosynovitis at seven months. Her symptoms improved transiently following emergent surgical open flexor sheath exploration and washout however, she required two further washouts; at eleven and thirteen months to improve symptoms. Viral cultures were obtained from the third washout as HSV infection was disclosed from further history taking. These were positive for HSV2. Treatment with acyclovir at thirteen months after presentation led to a complete resolution of her symptoms with no further recurrences to date. This rare case highlights the similarity in presentation between flexor sheath infection and herpetic whitlow which can lead to diagnostic confusion and mismanagement. We emphasise the importance of careful past medical history taking as well as considering herpetic whitlow as a differential diagnosis despite the presence of strongly positive Kanavel’s signs.

Muscle: Ischemia, Infarction, and Compartment Syndrome

2017 ◽  
Vol 21 (04) ◽  
pp. 443-458 ◽  
Author(s):  
Stephen Broski ◽  
Christin Tiegs Heiden ◽  
Michael Ringler
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Compartment Syndrome ◽  
Disease Process ◽  
Common Type ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Muscle Ischemia ◽  
Clinical Scenarios

AbstractMuscle ischemia and infarction are associated with a variety of pathologic conditions and commonly encountered in busy imaging practices. This article reviews the most common clinical scenarios in which they are seen including compartment syndrome, diabetic myonecrosis, and rhabdomyolysis, focusing on the imaging findings and differential diagnosis for each disease process. Magnetic resonance imaging is increasingly useful in differentiating myonecrosis from muscle ischemia and myositis, and it is highly accurate in diagnosing the most common type of compartment syndrome.

scholarly journals Supraclinoid Internal Carotid Arterial Aneurysm Presenting as a Suprasellar Mass-Like Lesion in a Child

2001 ◽  
Vol 7 (4) ◽  
pp. 357-361 ◽  
Author(s):  
D. Chul Suh ◽  
H. Alvarez ◽  
C. Sainte Rose ◽  
P. Lasjaunias
Keyword(s):  
Differential Diagnosis ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Visual Loss ◽  
Internal Carotid ◽  
Giant Aneurysm ◽  
Arterial Aneurysm ◽  
Endovascular Technique ◽  
Patient Will ◽  
Carotid Arterial

We present the case of a two-year and seven-month-old boy with a partially-thrombosed giant lobulated aneurysm in the supraclinoid portion of the internal carotid artery. He presented with several months of symptoms of progressive frontal headache and visual loss. CT revealed a large lobulated suprasellar mass lesion mimicking a craniopharyngioma. After the aneurysm was successfully obliterated by an endovascular procedure, regression of the giant aneurysm was confirmed on followed-up MRI. The differential diagnosis, possible etiologies, and the endovascular technique for pediatric patient will be discussed.

scholarly journals Epstein–Barr Virus-Induced Mononucleosis as an Imitator of Severe Preeclampsia

2017 ◽  
Vol 07 (01) ◽  
pp. e5-e7
Author(s):  
S. Staley ◽  
Marcela Smid ◽  
Sarah Dotters-Katz ◽  
Elizabeth Stringer
Keyword(s):  
Differential Diagnosis ◽  
Epstein Barr Virus ◽  
Liver Enzymes ◽  
Acute Infection ◽  
Supportive Treatment ◽  
Barr Virus ◽  
Ebv Infection ◽  
Elevated Liver Enzymes ◽  
Epstein Barr ◽  
In Pregnancy

Background In pregnancy, conditions presenting with hematologic abnormalities, transaminitis, and proteinuria pose diagnostic challenges in pregnancy. Case We present the case of an 18-year-old woman, G1P0, at 33 weeks' gestation with fever of unknown cause, who developed progressively elevated liver enzymes, proteinuria, and thrombocytopenia, due to Epstein–Barr virus (EBV) infection. Conclusion Acute infection with EBV should be included in the differential diagnosis of preeclampsia with severe features, particularly in the setting of fever. Supportive treatment and observation may prevent iatrogenic preterm birth.

scholarly journals Pericarditis after SARS-CoV-2 Infection: Another Pebble in the Mosaic of Long COVID?

Viruses ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 1997
Author(s):  
Francesco Carubbi ◽  
Alessia Alunno ◽  
Silvia Leone ◽  
Nicoletta Di Di Gregorio ◽  
Bernardina Mancini ◽  
...  
Keyword(s):  
Acute Infection ◽  
Disease Process ◽  
Nasopharyngeal Swab ◽  
Vaccination Programs ◽  
Persistent Symptoms ◽  
Number Of Patients ◽  
Pericardial Diseases ◽  
Suitable Treatment ◽  
The Relationship ◽  
Inflammatory Component

With the emerging success of the COVID-19 vaccination programs, the incidence of acute COVID-19 will decrease. However, given the high number of people who contracted SARS-CoV-2 infection and recovered, we will be faced with a significant number of patients with persistent symptoms even months after their COVID-19 infection. In this setting, long COVID and its cardiovascular manifestations, including pericarditis, need to become a top priority for healthcare systems as a new chronic disease process. Concerning the relationship between COVID-19 and pericardial diseases, pericarditis appears to be common in the acute infection but rare in the postacute period, while small pericardial effusions may be relatively common in the postacute period of COVID-19. Here, we reported a series of 7 patients developing pericarditis after a median of 20 days from clinical and virological recovery from SARS-CoV-2 infection. We excluded specific identifiable causes of pericarditis, hence we speculate that these cases can be contextualized within the clinical spectrum of long COVID . All our patients were treated with a combination of colchicine and either ASA or NSAIDs, but four of them did not achieve a clinical response. When switched to glucocorticoids, these four patients recovered with no recurrence during drug tapering. Based on this observation and on the latency of pericarditis occurrence (a median of 20 days after a negative nasopharyngeal swab), could be suggested that post-COVID pericarditis may be linked to ongoing inflammation sustained by the persistence of viral nucleic acid without virus replication in the pericardium. Therefore, glucocorticoids may be a suitable treatment option in patients not responding or intolerant to conventional therapy and who require to counteract the pericardial inflammatory component rather than direct an acute viral injury to the pericardial tissue.

Acute giardiasis and Chapman reflexes: Musculoskeletal symptoms preceding, during and after infection

2022 ◽  
pp. 19-22
Author(s):  
Leonard Powell, DO, MS, CMD. ◽  
Chad Richmond ◽  
Danielle Cooley
Keyword(s):  
Acute Infection ◽  
Parasitic Infection ◽  
Exercise Program ◽  
Disease Process ◽  
Complete Recovery ◽  
Musculoskeletal Symptoms ◽  
Secretory Diarrhea ◽  
Home Exercise ◽  
Home Exercise Program ◽  
Musculoskeletal Manifestations

Giardiasis is an acute infection caused by Giardia lamblia, which produces profuse secretory diarrhea that can lead to dehydration and electrolyte derangement. Musculoskeletal manifestations resulting because of giardiasis occur due to prolonged inflammation and viscero-somatic reflexes of the pathophysiology for this disease process. By treating the parasitic infection with an antiparasitic agent, as well as treating the somatic dysfunctions with osteopathic manipulative treatment, analgesics and a home exercise program, the patient in the following article experienced an uneventful course of treatment and a complete recovery including resolution of the pain.

Bilateral Massive Retinal Gliosis Associated With Retinopathy of Prematurity

2009 ◽  
Vol 133 (8) ◽  
pp. 1242-1245 ◽  
Author(s):  
S. K. Steven Houston ◽  
T. David Bourne ◽  
M. Beatriz S. Lopes ◽  
Nicola G. Ghazi
Keyword(s):  
Differential Diagnosis ◽  
Chronic Inflammation ◽  
Retinopathy Of Prematurity ◽  
Unusual Case ◽  
Congenital Abnormalities ◽  
Disease Process ◽  
Tissue Response ◽  
Vascular Disorders ◽  
First Report ◽  
Retinal Injury

Abstract Massive retinal gliosis (MRG) is a rare, benign intraocular condition that may develop in association with long-standing eye conditions including chronic inflammation, vascular disorders, glaucoma, trauma, or congenital abnormalities. It is thought to represent a nonneoplastic reactive tissue response to retinal injury. Here, we describe an unusual case of bilateral MRG in association with retinopathy of prematurity. To our knowledge, this may be the first report of such an occurrence. The differential diagnosis of MRG is discussed with specific emphasis on its relationship to vasoproliferative tumor of the retina and presumed acquired retinal hemangiomas. In addition, we hypothesize that MRG, vasoproliferative tumor of the retina, and presumed acquired retinal hemangiomas may represent different phenotypes along a spectrum of the same disease process.

Cat Bite

2018 ◽  
pp. 146-150
Author(s):  
Martin Casey
Keyword(s):  
Emergency Room ◽  
Wound Closure ◽  
Hand Infection ◽  
Severity Of Injury ◽  
Animal Bites ◽  
Flexor Tenosynovitis ◽  
Invasive Management

This case reviews the basics in caring for patients with animal bites. Specifically, the chapter will demonstrate a case of flexor tenosynovitis, a severe hand infection that may be the result of common animal bites. Critical steps will be reviewed including identifying the severity of injury and when consultation for invasive management, such as surgery, may be indicated. Wound closure, antibiotic choice, and indications for rabies prophylaxis are discussed as well. The chapter focuses on a case of a cat bite. The patient presents to the emergency room with a 1-day prior cat bite. The chapter reviews her symptoms, such as swelling, pain, and erythema.

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