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J Hand Microsurg 2018; 10(01): 041-045
DOI: 10.1055/s-0037-1606627
Case Report
Thieme Medical and Scientific Publishers Private Ltd.

Deep Invasive Fungal Infection of the Hand in a Child Mimicking a Local Gigantism

Anirban Chatterjee
1   Department of Orthopedics, Medica Superspecialty Hospital, Kolkata, West Bengal, India
,
Shamita Chatterjee
2   Department of Surgery, NRS Medical College, Kolkata, West Bengal, India
› Author Affiliations
Further Information

Publication History

Received: 28 February 2017

Accepted: 08 August 2017

Publication Date:
27 November 2017 (online)

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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
 

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