A neonate with multiple hand flexor tendon ruptures due to methicillin-susceptible Staphylococcus aureus sepsis: a case report

Abstract

Background Neonatal pyogenic tenosynovitis is a highly emergent soft tissue infection. We report a case of a neonate with pyogenic tendinopathy and tendon rupture diagnosed by ultrasonography (US). He subsequently developed pyogenic arthritis and osteomyelitis during antimicrobial therapy. Case presentation A 7-day-old boy was admitted to our hospital with redness and swelling of the right index finger. US on admission showed rupture of the flexor tendon of the right index finger with inactivity. The day after admission, he developed pyogenic arthritis of the right elbow and, subsequently, pyogenic osteomyelitis. Staphylococcus aureus was identified through bacterial culture, and the patient was treated with intravenous antibiotics for 6 weeks. However, after discharge from our hospital, rupture of the flexor tendon of the left thumb was confirmed. A two-stage flexor tendinoplasty was completed at the age of 2 years and 1 month for the flexor tendon rupture on his right index finger. Conclusions In addition to blood culture, ultrasonographic evaluation should be performed in neonates with erythematous and swollen joints to identify the focus of infection as soon as possible. Moreover, repeated regular US examination is important in the follow-up of bone and soft tissue infections.

Revisão sistemática: uso de exames de imagem no auxílio diagnóstico de Tenossinovite Infecciosa

“…No relato de Nakamuara et al (17) , a US mostrou identificou ruptura do tendão FLP esquerdo. Na pesquisa de Mohn et al (6) foi realizado um exame ultrassonográfico das polias, bainhas dos tendões e tendões em um plano transversal, que identificou que a lesão ocorreu exclusivamente no dedo médio ou anular (58,5% e 55,4%, respectivamente), exceto em um caso em que o quinto dedo foi acometido.…”

“…De acordo com os autores, a Candida albicans é uma causa rara de tenossinovite infecciosa. E segundo Nakamuara et al (17) , além da hemocultura, a avaliação ultrassonográfica deve ser realizada em neonatos com articulações eritematosas e edemaciadas para identificar o foco de infecção o mais rápido possível. Além disso, o exame regular repetido de US é importante no acompanhamento de infecções ósseas e de tecidos moles.…”