background

• Infection within the flexor tendon sheath
• Penetrating injury may not be recalled
• Finger in slight fixed flexion (position of rest)
• Tender along tendon sheath with pain on passive extension
• Systemic signs / fever are rare

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Pathogens

• Skin commensals (Staph aureus and group A Strep)
• Pasteurella multocida if cat bite
• Eikenella corrodens infection in human bite wounds
• ? N gonorrhoeae if no trauma and Hx immunocompromised or HIV/AIDS

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Beware

• Check blood glucose - DM mixed gram negatives
• Consider rheumatoid factor - Gram negatives
• ? possible IVDU - Gram positive bugs
• Fish spines - (mycobacterium!)

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Treatment

• Analgesia, rings off, elevate
• IV antibiotics (and ATT as required)
• FBC, Renal Fxn, culture pus or blood samples
• Admit plasitcs for washout under GA