title: Tropical Diabetic Hand Syndrome.
abstract: 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.
authors.affiliation: Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria.
authors.forename: T C
authors.initials: TC
authors.lastname: Okpara
authors.affiliation: Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria; Department of Medicine, Enugu State University of Science and Technology Teaching Hospital, Parklane, Enugu, Nigeria.
authors.forename: B A
authors.initials: BA
authors.lastname: Ezeala-Adikaibe
authors.affiliation: Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria.
authors.forename: O
authors.initials: O
authors.lastname: Omire
authors.affiliation: Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria.
authors.forename: E
authors.initials: E
authors.lastname: Nwonye
authors.affiliation: Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria.
authors.forename: J
authors.initials: J
authors.lastname: Maluze
keywords: Diabetes; Hyperglycemia; Nigeria; Tropical diabetic hand syndrome