Li Di, Gao Wenshan, Niu Yanan, Zhao Pei, Zheng Wenkui, Li Cong Jie
Department of Orthopedics, Affiliated Hospital of Hebei University, Baoding, China.
Medicine (Baltimore). 2019 Jan;98(2):e14002. doi: 10.1097/MD.0000000000014002.
Digital infection is a common disease in clinic, featured by pain and swelling of digits. As far as we know, no article has reported a case of digital infected by Morganella morganii.
A 58-year-old Chinese female complains about whitlow with pain and swelling for 2 weeks. She has a history of diabetes for 10 years. She received incision and drainage before coming to our hospital and preoperative X-ray of left ring finger presented no bone eroded.
She is diagnosed with infection of ring finger caused by M morganii in our hospital.
We perform aggressive operative debridement and drainage firstly. Meanwhile, we provide tissue samples for diagnosis and the result indicates M morganii infection. Then, she is treated with anti-infection therapy and regulation of diabetes. However, 1 week after first surgery, her condition deteriorate presenting bone erosion in distal phalanx of ring finger from X-ray. Considering severity of illness, we decide to perform digital amputation.
At 3-month follow-up, the patient has a satisfactory result and X-ray shows no bone eroded.
Clinicians should consider M morganii, which is rare in hand infection, as a cause of digital infection. This case reminds us that some whitlow is dangerous, amputation should be considered if necessary.
手指感染是临床上的常见疾病,以手指疼痛和肿胀为特征。据我们所知,尚无文章报道过摩根摩根菌感染手指的病例。
一名58岁的中国女性因甲沟炎伴疼痛和肿胀2周前来就诊。她有10年糖尿病病史。在来我院之前她接受了切开引流术,术前左手环指X线片显示无骨质侵蚀。
我院诊断她为摩根摩根菌引起的环指感染。
我们首先进行积极的手术清创和引流。同时,我们提供组织样本进行诊断,结果显示为摩根摩根菌感染。然后,她接受抗感染治疗和糖尿病调控。然而,首次手术后1周,她的病情恶化,X线显示环指远节指骨出现骨质侵蚀。考虑到病情的严重性,我们决定进行手指截肢术。
在3个月的随访中,患者恢复情况良好,X线显示无骨质侵蚀。
临床医生应将手部感染中罕见的摩根摩根菌视为手指感染的病因之一。该病例提醒我们,有些甲沟炎很危险,必要时应考虑截肢。