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. 2009 Sep;4(3):335-8.
doi: 10.1007/s11552-009-9178-7. Epub 2009 Mar 4.

Phaeohyphomycosis infection leading to flexor tendon rupture: a case report

Jaskarndip Chahal  1 , Herman S Dhotar, Dimitri J Anastakis
Affiliations

Phaeohyphomycosis infection leading to flexor tendon rupture: a case report

Jaskarndip Chahal et al. Hand (N Y). 2009 Sep.

Abstract

A rare previously unreported cause of flexor tendon rupture is described. A 66-year-old man presented with a fully extended left middle finger, accompanied by swelling and purulent drainage. Prior to presentation, he had received a steroid injection for left middle finger stenosing tenosynovitis and subsequently developed culture-proven phaeohyphomycosis fungal infection and secondary enterococcal bacterial infection, requiring pharmacotherapy and incision, drainage, and debridement for abscess formation. Clinical and magnetic resonance imaging findings were consistent with the diagnosis of closed flexor tendon rupture of the left middle finger. Antifungal and antibiotic therapy followed by two-stage flexor tendon reconstruction was performed. Six months postoperatively, full passive range of motion was achieved and the proximal interphalangeal and distal interphalangeal joints of the left middle finger actively flexed to 125 degrees and 90 degrees, respectively.

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Figures

Figure 1
Figure 1
a Preoperative axial T1-weighted MRI demonstrating a non-specific mass involving the FDP tendon of the left middle finger. b Preoperative coronal T2-weighted MRI demonstrating a longitudinal split tear involving the FDS tendon of the left middle finger.
Figure 2
Figure 2
Excision of the FDS, FDP, and flexor sheath during stage one flexor tendon reconstruction.
Figure 3
Figure 3
a Active flexion of the left hand, post second stage flexor tendon reconstruction. b Active extension of the left hand, post second stage flexor tendon reconstruction.
See this image and copyright information in PMC

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