Description
In this presentation, David Lawrie, a consultant surgeon based in Aberdeen, provides an insightful overview of atypical infections affecting the hand. He opens with a warm welcome to attendees and humor about Aberdeen's typically rainy weather, setting a friendly tone. Moving into the core of his presentation, he highlights how common infections related to the hand often arise due to environmental exposure in daily activities, leading to conditions like acute pain, erythema, and discharge.
Lawrie emphasizes the significance of being vigilant for less common infections, which may not respond to standard treatments. He introduces the concept of an index of suspicion, particularly in cases involving immunocompromised patients. Throughout his talk, he references various atypical pathogens, including mycobacterium species, viral infections, and fungi, explaining their unique presentations, diagnosis challenges, and treatment approaches. For instance, he shares a case involving a 64-year-old farmer who developed a mycobacterial infection, which required a synovectomy and specialized microbiological testing to identify the rare organism, mycobacterium microti.
In discussing tuberculosis (TB) infections in the hand, Lawrie explains their presentation as synovial infections or osteomyelitis, stressing the need for careful diagnosis and collaboration with infectious disease specialists. He also covers common viral infections like herpes simplex and discusses cutaneous papillomavirus infections in work settings, underlining the treatment nuances.
Lawrie further explores fungal infections related to chronic conditions stemming from occupational exposures, such as candidiasis from prolonged hand washing. He touches on other rare conditions like sporotrichosis, detailing the progression and treatment options.
In summary, Lawrie advocates for a thorough history-taking and awareness of atypical infection signs, encouraging collaboration with microbiology teams to ensure appropriate treatment pathways. His closing remarks lead to an engaging Q&A session, where colleagues share their clinical experiences, enhancing the dialogue around diagnosing and treating unusual hand infections.