title: Eosinophilic fasciitis: case report.
abstract: A 16-year-old healthy boy presented with an acute claw hand and signs of flexor tenosynovitis or possible necrotizing fasciitis of all 4 fingers in 1 hand. After an operative incision and drainage and treatment with antibiotic, the patient improved; cultures were negative. He relapsed shortly after completing the 10-day course of antibiotics. A second incision and drainage was performed. Cultures from the second operation also revealed no infectious agent. The pathological report indicated a diagnosis of eosinophilic fasciitis. Our patient improved on antibiotics and nonsteroidal anti-inflammatory medication and has since had no further relapse. Eosinophilic fasciitis should be considered in the setting of acute claw hand and physical examination findings consistent with necrotizing fasciitis in which no infection is identified. One should consider biopsies as well as cultures during operative intervention in cases that clinically mimic serious infection but do not have purulence.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, Yale-New Haven Hospital, New Haven, Connecticut.. Electronic address: andrea.lese@yale.edu.
authors.forename: Andréa B
authors.initials: AB
authors.lastname: Lese
authors.forename: Seth D
authors.initials: SD
authors.lastname: Dodds
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D002981:Clindamycin / Q000008:administration & dosage; D004802:Eosinophilia / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005208:Fasciitis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006225:Hand; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012008:Recurrence; D012086:Reoperation; D013717:Tenosynovitis / Q000175:diagnosis
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002981:Clindamycin
keywords: Eosinophilic fasciitis