Chronic Infections

Patel, Mukund R.; Gn, Malaviya

doi:10.1016/b978-1-4160-5279-1.00004-6

Cited by 6 publications

(6 citation statements)

References 85 publications

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“…The paediatric bone is porous and more vascular. Increased vascularity predisposes lodging of bacteria into osseous tissue and may sometimes lead to multiple bony involvements [22]. In our series, we had one bilateral involvement and eight patients had the involvement of more than one bone in the unilateral hand.…”

Section: Discussionmentioning

confidence: 98%

“…Kotwal et al [5], in their description of 32 patients, did not encounter even a single case of multiple involvement. Also, the periosteum in paediatric bone has more osteogenic potential and the presence of growth plates at the ends enhances the overall regenerative and remodelling capacity of bone [22]. A radiological picture of 'spina ventosa' because of progressive resorption of the bony cortex accompanied by subperiosteal hyperplasia is also unique to paediatric infection [6].…”

Section: Discussionmentioning

confidence: 98%

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Hand and wrist tuberculosis in paediatric patients – our experience in 44 patients

Prakash

Mehtani

2017

Journal of Pediatric Orthopaedics B

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Skeletal tuberculosis (TB) of the hand and wrist is rare, accounting for less than 1% of all osteoarticular TB. Although rare, TB of the hand and wrist is a cause of major morbidity. A common feature among all available reports on TB of the hand and wrist was a delay in diagnosis, causing residual stiffness and pain after treatment. Minimal initial symptoms, rarity of the lesion and ability of wrist TB to mimic more common pathologies account for the delay. Skeletal TB may behave differently in this age compared with the adult population. Further, the disease may affect the growing bone, causing residual deformities. The paucity of studies from different countries, coupled with a difficulty in diagnosis resulting in major morbidity, led us to carry out a study on this topic. A total of 44 patients with skeletal lesions in the hand and wrist were studied. The diagnosis was confirmed by biopsy. Patients were started on multidrug antitubercular treatment (ATT). Those not responding were scheduled for debridement. All patients were assessed using the Green O'Brian scoring system. All these patients were studied separately for clinical presentation, nutritional status (Rainey-Mcdonald nutritional index), time from onset of symptoms to presentation, treatment required, prognosis and complications. The proximal phalanx of the fourth digit and the metacarpal of the fifth digit were the most commonly involved bones in our series, with five cases of each. The capitate was the most common carpal bone, followed by the lunate. The duration of symptoms ranged from 5 weeks to 24 weeks (mean: 7.6 weeks). Most of these patients presented with complaints of pain, followed by swelling. 13 patients did not respond favourably to ATT over an 8-week period and were scheduled for surgery. Three of these patients had multidrug resistance. There was one case of a pathological fracture in our series and seven cases of arthritis/residual significant pain at the end of follow-up. For all the other patients, the results were excellent. A very high index of suspicion, MRI and early biopsy are required for a timely diagnosis of skeletal TB of the hand and wrist. Early commencement of ATT was the most important factor for good results. The possibility of multidrug resistance should be kept in mind for patients not responding to treatment.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Hand and wrist tuberculosis in paediatric patients – our experience in 44 patients

Prakash

Mehtani

2017

Journal of Pediatric Orthopaedics B

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“…This presentation is commonly seen as single-digit involvement in adults, although multiple digits can also be involved. [ 10 11 12 13 14 ] Common aetiologies include gout, sarcoidosis, atypical mycobacterial infection, chronic fungal infection and leukaemia.…”

Section: Discussionmentioning

confidence: 99%

“…Patel [ 10 ] advised to vary the duration of chemotherapy based on the tissue involved – 6 months for cutaneous infections, 9 months for tenosynovial involvement and 1 year when bone is infected. In endemic areas, an empirical course of ATT is started in the presence of typical clinical features and a positive smear or culture is not required in all cases.…”

Section: Discussionmentioning

confidence: 99%

‘Sausage finger’ with ‘Rice bodies’

Reddy

Upadhyaya

Jaiswal

et al. 2018

Indian J Plast Surg

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Although both pulmonary and extrapulmonary tuberculosis (TB) are commonly encountered in developing countries, tenosynovitis is an uncommon presentation of musculoskeletal TB. TB mimics a lot of other conditions and causes diagnostic dilemma in day-to-day practice. We present the case of a 30-year-old male who presented with the complaints of swelling of right index finger which was initially suspected to be giant cell tumour of the flexor tendon sheath but on histological examination turned out to be tuberculous tenosynovitis.

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“…Primary closure is the preferred method of wound management and results in a less obvious scar than does secondary healing. [ 5 ] Prevention is the most effective way of treating the disease. Providing hygiene conditions at work and using barriers like gloves are believed to prevent sinus formation.…”

Section: Case Reportsmentioning

confidence: 99%

Interdigital pilonidal sinus, report of two cases

et al. 2016

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Hairdresser's disease is an occupational acquired interdigital pilonidal sinus (IPS) of especially male barbers. Here, two cases of IPSs are reported. Both cases underwent surgical excision and primary closure. Six months follow-up period did not present any complications or recurrence. Caused by repeated implantation of foreign hair to the interdigital web space, IPS is preventable, but once acquired treated with surgical excision and primary closure or with a skin flap for postoperative comfort.

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Chronic Infections

Cited by 6 publications

References 85 publications

Hand and wrist tuberculosis in paediatric patients – our experience in 44 patients

Hand and wrist tuberculosis in paediatric patients – our experience in 44 patients

‘Sausage finger’ with ‘Rice bodies’

Interdigital pilonidal sinus, report of two cases

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