Evgeniou Evgenios, Iyer Srinivasan
Department of Plastic Surgery, Wexham Park Hospital, Slough, Berkshire, UK.
BMJ Case Rep. 2012 Aug 24;2012:bcr2012006778. doi: 10.1136/bcr-2012-006778.
Flexor tenosynovitis is an aggressive closed-space infection of the digital flexor tendon sheaths of the hand. We present a case of pyogenic flexor tenosynovitis in an immunocompromised patient and discuss the importance of early diagnosis and referral to a specialist hand surgery unit. A 61-year-old man visited his general practitioner because of swelling and tenderness of his left index finger. The patient was discharged on oral antibiotics but returned 4 days after because of deterioration of his symptoms and was referred to a plastic surgery unit. A diagnosis of flexor tenosynovitis was made and the patient required multiple debridements in theatre, resulting in the amputation of the infected finger. Pyogenic flexor tenosynovitis is a relatively common but often misdiagnosed hand infection. Patients with suspected flexor tenosynovitis should be referred and treated early to avoid significant morbidity, especially when risk factors for poor prognosis are present.
屈指肌腱腱鞘炎是手部指屈肌腱鞘的一种侵袭性的密闭空间感染。我们报告一例免疫功能低下患者的化脓性屈指肌腱腱鞘炎病例，并讨论早期诊断及转诊至专业手外科科室的重要性。一名61岁男性因左手示指肿胀和压痛就诊于其全科医生。患者口服抗生素后出院，但4天后因症状恶化复诊，并被转诊至整形外科。诊断为屈指肌腱腱鞘炎，患者在手术室接受了多次清创，最终感染手指被截肢。化脓性屈指肌腱腱鞘炎是一种相对常见但常被误诊的手部感染。疑似屈指肌腱腱鞘炎的患者应尽早转诊并接受治疗，以避免出现严重的发病情况，尤其是存在预后不良的危险因素时。
