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2015 ; 5
(6
): 473-5
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Tropical Diabetic Hand Syndrome
#MMPMID27057390
Okpara TC
; Ezeala-Adikaibe BA
; Omire O
; Nwonye E
; Maluze J
Ann Med Health Sci Res
2015[Nov]; 5
(6
): 473-5
PMID27057390
show ga
Any adult with diabetes in the tropics with hand cellulitis, infection and
gangrene qualifies for tropical diabetic hand syndrome (TDHS). We reviewed a
39-year-old woman with a 3-week history of swelling of the left index finger
following an insect bite. The swelling progressively increased in size, was very
painful, and extended to the palm. There was no history or symptoms suggestive of
chronic complications of diabetes. Random blood sugar on presentation was above
600 mg/dl using a glucometer. Examination revealed an edematous left palm
draining pus from multiple sinuses, necrotic and gangrenous left index finger
extending down to just above the thenar eminence. A diagnosis of TDHS in a
patient with hyperosmolar state was made. She was managed accordingly and
subsequently underwent aggressive debridement and desloughing. Two fingers were
amputated and the wound was allowed to heal by secondary intention.