Abstract
Subcutaneous and deep fungal infections in the hand are rare among children. These
are usually found in immunocompromised adults or in persons engaged in soil handling
activities, due to direct exposure, especially in the tropics. Delay in diagnosis
is usual because pyogenic and other granulomatous infections are considered first.
The authors present the case of a healthy, immunocompetent 2½-year-old child who presented
with progressive swelling of the right hand mimicking a localized gigantism of the
entire hand. Multiple operative drainage procedures done previously had failed to
resolve the condition. A biopsy established the presence of fungal hyphae, thus confirming
the diagnosis of deep fungal infection of the hand and guided proper therapeutic intervention.
A strong index of suspicion needs to be maintained in cases not responding to conventional
antibacterial therapy, and both microbiologic and histopathologic samples need to
be obtained to establish the diagnosis.
Keywords
pediatric hand infection - deep fungal infection - local gigantism
