Pediatric Unilateral Infectious Flexor Tenosynovitis: A Case Report

Author(s)

Pritika ShahFollow

Speaker Credentials

OMS-I

Speaker Credentials

BS

College

Dr. Kiran C. Patel College of Osteopathic Medicine, DO

Medical Specialty

General Surgery

Format

Poster

Start Date

November 2024

End Date

November 2024

Track

3

Abstract

Infectious flexor tenosynovitis is a vigorous pyogenic inflammation of the synovium in the flexor sheath that surrounds the tendons in phalanges, often requiring prompt antibiotic therapy and surgical interventions to minimize adverse outcomes. This case presents as a 10yr old Caucasian female who arrives to the pediatric emergency department, with no past medical history, with significant swelling and redness to the left ring finger and pain with extension of the finger. Patient denied any direct trauma, and radiographs revealed no acute fracture or dislocation, however diffused soft tissue swelling and fluid accumulation surrounding the flexor tendon sheath was present. Since the patient displayed all of the Kanavel signs, with elevated WBC and CRP, she was diagnosed with flexor tenosynovitis. Patient was started on IV antibiotics and taken for surgery to drain the deep abscess, perform an A1 pulley release, and irrigation of flexor tendon sheath. At the follow up, the patient had a pyogenic granuloma mass at surgical site, and underwent surgery to excise the granulomatous tissue and cauterize the base to prevent future granulomas. This case emphasizes the importance of considering flexor tenosynovitis when examining pediatric patients with extremity edema, tenderness, and pain, even if the history does not include direct trauma to affected digit. Early diagnosis and IV/ surgical interventions are vital in the prevention of adverse effects caused by Staphylococcus aureus. Effective treatment plans should include prompt debridement, microbial recognition with susceptibility testing, and adequate antibiotic coverage. This study was not receive or require any funding.

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Nov 13th, 10:12 AM Nov 13th, 10:20 AM

Pediatric Unilateral Infectious Flexor Tenosynovitis: A Case Report

Infectious flexor tenosynovitis is a vigorous pyogenic inflammation of the synovium in the flexor sheath that surrounds the tendons in phalanges, often requiring prompt antibiotic therapy and surgical interventions to minimize adverse outcomes. This case presents as a 10yr old Caucasian female who arrives to the pediatric emergency department, with no past medical history, with significant swelling and redness to the left ring finger and pain with extension of the finger. Patient denied any direct trauma, and radiographs revealed no acute fracture or dislocation, however diffused soft tissue swelling and fluid accumulation surrounding the flexor tendon sheath was present. Since the patient displayed all of the Kanavel signs, with elevated WBC and CRP, she was diagnosed with flexor tenosynovitis. Patient was started on IV antibiotics and taken for surgery to drain the deep abscess, perform an A1 pulley release, and irrigation of flexor tendon sheath. At the follow up, the patient had a pyogenic granuloma mass at surgical site, and underwent surgery to excise the granulomatous tissue and cauterize the base to prevent future granulomas. This case emphasizes the importance of considering flexor tenosynovitis when examining pediatric patients with extremity edema, tenderness, and pain, even if the history does not include direct trauma to affected digit. Early diagnosis and IV/ surgical interventions are vital in the prevention of adverse effects caused by Staphylococcus aureus. Effective treatment plans should include prompt debridement, microbial recognition with susceptibility testing, and adequate antibiotic coverage. This study was not receive or require any funding.