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M. Tuberculosis
Clincial presentation similar to RA
M. Marinum
Is the apecies most often responsible for hand infections
Common contaminant of warm water environments, exposure typically occurs when the patient suffers a skin abrasion or puncture wound while at the beach, lake, river or pool or while working with a fish tank
Presents as either a chronic ulceration or a lovalised tenosynovitis along the digital flexor sheath, carpal canal or extensor tendons over the dorsum of the wrist
Deep infections are treated by surgical synovectomy and prolonged antiTB meds
Viruses
Herpetic whitlow is a superficial infection that manifests as clear vesicles on or near the finger pad
Often seen in children and medical/dental personnel
May or May not be a history of herpes simplex infection
May be accompanied by axillary and epitrpchlear adenopathy
Diagnosis can be made on clinical appearance and confirmed using fluorescent antibody test
Will run its own course over 2 ro 4weeks, IV antibiotics and acyclovir may be utilised to limit the duration of rhe outbreak.
I & D should be avoided as it prolongs recovery and maý lead to a bacterial superinfection
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