Department of Orthopedic Surgery, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Orthopedics, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2024 May;26(5):304-308.
Pyogenic flexor tenosynovitis (PFT) is a common and severe hand infection. Patients who present early can be treated with intravenous antibiotics.
To determine whether PFT caused by animal bites and treated with antibiotics leads to a different outcome than other disease etiologies due to the extensive soft tissue insult and different bacterial flora.
We conducted a retrospective cohort study of 43 consecutive patients who presented with PFT between 2013 and 2020. The 10 patients who presented with PFT following an animal bite were compared to those who presented with PFT caused by any other etiology.
Patients who were bitten pursued medical attention sooner: 1.9 ± 1.4 days compared with 5.3 ± 4.7 days (P = 0.001). Despite the quicker presentation, patients from the study group received similar antibiotic types and duration as controls. All patients were initially treated with intravenous antibiotics under surveillance of a hand surgeon. One patient (10%) from the study group and four controls (12%) were treated surgically (P = 1). Average follow-up was 17 ± 16 days. At the end of follow-up, one (10%) patient from the study group and three (9%) controls sustained mild range of motion limitation and one (3%) patient from the control group had moderate limitations (P = 0.855).
Intravenous antibiotic treatment, combined with an intensive hand surgeon follow-up, is a viable option for the treatment of PFT caused by animal bites.
脓性屈肌腱腱鞘炎（PFT）是一种常见且严重的手部感染。早期就诊的患者可采用静脉内抗生素治疗。
确定因动物咬伤引起的 PFT 并经抗生素治疗后是否因广泛的软组织损伤和不同的细菌菌群而导致与其他病因引起的 PFT 不同的结果。
我们对 2013 年至 2020 年间连续 43 例 PFT 患者进行了回顾性队列研究。将 10 例因动物咬伤引起的 PFT 患者与其他病因引起的 PFT 患者进行比较。
就诊较早：1.9 ± 1.4 天与 5.3 ± 4.7 天（P = 0.001）。尽管就诊时间较早，但研究组患者接受的抗生素类型和持续时间与对照组相似。所有患者均在手部外科医生的监测下首先接受静脉内抗生素治疗。研究组有 1 例（10%）患者和对照组有 4 例（12%）患者需要手术治疗（P = 1）。平均随访时间为 17 ± 16 天。随访结束时，研究组有 1 例（10%）患者和对照组有 3 例（9%）患者出现轻度活动度受限，对照组有 1 例（3%）患者出现中度受限（P = 0.855）。
静脉内抗生素治疗结合手部外科医生的强化随访是治疗动物咬伤引起的 PFT 的可行选择。
