An Unexpected Cause of Tenosynovitis

Chou, Louisa; Day, Jessica; Ciciriello, Sabina

doi:10.3899/jrheum.150968

Cited by 1 publication

(1 citation statement)

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“…Single therapy was prescribed in 9/18 cases (50%). Of those, 6/18 (33%) received fluoroquinolones [levofloxacin 5/6 (83%) ( Chee and Baddour, 2007 ; Loridant et al., 2011 ; Mentula et al., 2014 ; Desgranges et al., 2020 ) and ciprofloxacin 1/6 (17%) ( Chou et al., 2016 )], and 3/18 (15%) received macrolides [clarithromycin 1/3 (33%) ( Qin et al., 2002 ), erythromycin 1/3 (33%) ( Waldor et al., 1993 ), and azithromycin 1/3 (33%) ( Padrnos et al., 2014 )]. Combination therapy of fluoroquinolones and macrolides was prescribed in 3/18 (15%) ( Han et al., 2010 ; Neiderud et al., 2013 ; Grimstead et al., 2015 ).…”

Section: Resultsmentioning

confidence: 99%

Legionella longbeachae wound infection: case report and review of reported Legionella wound infections

Frostadottir

Wasserstrom

Lundén

et al. 2023

Front. Cell. Infect. Microbiol.

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Extrapulmonary manifestations of infection with Legionella species, of which 24 may cause disease in humans, are very rare. Here, we describe a case of a 61-year-old woman with no history of immunosuppression presenting with pain and swelling of her index finger after a prick by rose thorns during gardening. Clinical examination showed fusiform swelling of the finger with mild redness, warmth, and fever. The blood sample revealed a normal white blood cell count and a slight increase in C-reactive protein. Intraoperative observation showed extensive infectious destruction of the tendon sheath, while the flexor tendons were spared. Conventional cultures were negative, while 16S rRNA PCR analysis identified Legionella longbeachae that also could be isolated on buffered charcoal yeast extract media. The patient was treated with oral levofloxacin for 13 days, and the infection healed quickly. The present case report, with a review of the literature, indicates that Legionella species wound infections may be underdiagnosed due to the requirement for specific media and diagnostic methods. It emphasizes the need for heightened awareness of these infections during history taking and clinical examination of patients presenting with cutaneous infections.

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