Primary actinomycotic osteomyelitis of metacarpal bones managed successfully with surgical debridement and Welsh regimen.

Autor:	K Manjunath S; Orthopaedics, Kasturba Medical College Manipal, Manipal, Karnataka, India sagarika.manjunath@learner.manipal.edu., Pandey V; Orthopaedics, Kasturba Medical College Manipal, Manipal, Karnataka, India., B K AR; Orthopaedics, Kasturba Medical College Manipal, Manipal, Karnataka, India., Varma M; Infectious Diseases, Kasturba Medical College Manipal, Manipal, Karnataka, India.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2024 Nov 04; Vol. 17 (11). Date of Electronic Publication: 2024 Nov 04.
DOI:	10.1136/bcr-2024-261536
Abstrakt:	Mycetoma of the hand is a chronic granulomatous disease seen in the tropics and subtropical regions, mainly affecting the skin and subcutaneous tissue of the foot. Primary actinomycotic osteomyelitis involving the metacarpals is rarely reported in the literature. The conventional treatment for actinomycosis has been high-dose penicillin. We report a case of chronic osteomyelitis in the metacarpals of the hand caused by actinomycetes in a woman in her 40s. She underwent surgical intervention in the form of wound debridement and curettage, followed by a 6-month course of Welsh regimen after a biopsy confirmed the diagnosis of actinomycotic osteomyelitis. This case report underscores the importance of recognising primary actinomycosis as a potential cause of chronic osteomyelitis at unusual sites and highlights the efficacy of combined surgical debridement, biopsy and adequate antibiotic management in consultation with infectious disease specialists in achieving good outcomes. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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