Annals of Case Reports and Clinical Studies (ISSN: 2834-5673) | Volume 3, Issue 1 | Case Report | Open Access DOI

A Curious Case of Non Healing Sinus in the First Web Space

Sanjay Chatterjee*

Keshavi Mehta1, Sanjay Chatterjee2*

1Postgraduate Student, Department Of General Surgery, Bombay Hospital, New Marine Lines, Mumbai, Maharashtra, India

2Assistant Professor, Maharashtra University of health sciences, Nashik, Postgraduate Teacher, Bombay hospital Institute of Medical Sciences, Mumbai, India

*Correspondence to: Sanjay Chatterjee 

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Abstract

Introduction: Tuberculosis is a chronic, infectious disease that has been a growing concern worldwide. It predominantly affects the respiratory system. Of the various extra pulmonary manifestations, the least common is cutaneous tuberculosis. It then spreads to adjacent soft tissue and bones leading to osteomyelitis. Thus, a high index of suspicion is needed when patients present with atypical skin lesions and non healing sinus or ulcers to avoid dissemination of the pathology.

Case Summary: We report a case of a 70 year old male, who presented with a non healing sinus in the first web space of left hand 3 months after a minor surgical procedure following trauma to the left palm along with 2 non healing ulcers near the elbow of the same hand. There was no resolution of symptoms even after adequate antibiotic course. MRI revealed 84x22mm collection/abscess and FNAC of the left axillary lymph node was then done which revealed a tuberculous infection.

Conclusion: A high suspicion for tuberculosis should be maintained when a patient presents with a chronic, unusual lesion which cannot be explained otherwise. There might or might not be systemic manifestations of tuberculosis or history of TB exposure. Faster diagnosis and complete anti-tubercular treatment prevents spread to deeper structures and thus life threatening complication.

Keywords:

Non healing sinus, Non healing ulcers, Cutaneous tuberculosis, Hand

Citation:

Keshavi Mehta, Sanjay Chatterjee.A Curious Case of Non Healing Sinus in the First Web Space. AnnCaseRepClinStud. 2023;3(1):1-7.