Li Jefferson, Fata Cynthia R, Laningham Fred, Naeem Fouzia, Galvez Michael G
Department of Orthopaedic Surgery, University of California, San Francisco: Fresno, Fresno, CA.
Department of Pathology, Valley Children's Hospital, Madera, CA.
J Hand Surg Glob Online. 2023 Feb 10;5(3):363-367. doi: 10.1016/j.jhsg.2022.12.007. eCollection 2023 May.
Disseminated coccidioidomycosis is a rare cause of flexor tendon tenosynovitis, particularly in the pediatric population. We present the case of a 2-month-old male infant with disseminated coccidioidomycosis of the right index finger, which was initially treated with debridement and long-term antifungal therapy. Six months after discontinuing antifungal medications and at the age of 2 years, the patient presented with relapse of coccidioidomycosis of his right index finger. Serial debridement and long-term antifungal therapy resulted in disease quiescence. The relapse of pediatric coccidioidomycosis tenosynovitis using surgical management with accompanying magnetic resonance imaging, histopathology, and intraoperative findings is described herein. Coccidioidomycosis should be considered for the differential diagnosis of pediatric patients who have traveled to or live in endemic areas and present with indolent hand infections.
播散性球孢子菌病是屈肌腱腱鞘炎的罕见病因，在儿科人群中尤为如此。我们报告一例2个月大的男婴，其右手食指患有播散性球孢子菌病，最初接受了清创术和长期抗真菌治疗。在停用抗真菌药物6个月后，该患儿2岁时，右手食指球孢子菌病复发。连续清创术和长期抗真菌治疗使病情得到缓解。本文描述了小儿球孢子菌性腱鞘炎复发采用手术治疗，并伴有磁共振成像、组织病理学和术中所见。对于去过或居住在流行地区且出现手部慢性感染的儿科患者，鉴别诊断时应考虑球孢子菌病。
