Inguinal Flap Implementation In Diabetic Hand Infection With Complicated Invasive Candidiasis

Abstract

Although hand infections in diabetic patients are observed less frequently than foot infections, hand infections may cause severe problems, such as stiffness and loss of skin, nerve and bone persisting even after the infection resolves. Invasive soft tissue fungal infections are very rare among diabetes-related limb infections. In this report, we present a case of diabetic hand infection with invasive candidiasis. A 53-year-old female patient was admitted to our Ege University Diabetic Foot Council with necrosis and bullae at the tip of the third finger of her right hand. For surgical treatment, wound debridement and amputation were performed and a broad-spectrum antibiotic treatment was started. The tissue culture yielded Candida albicans and the patient was successfully treated with fluconazole. Inguinal flap operation was performed after antifungal (fluconazole) therapy. However, purulent discharge and ischemia with superficial necrosis of the flap developed on follow up. Thereupon, surgical debridement was performed again and antibiotic treatment was started. With the treatment of infection, flap success was achieved. Routine evaluation during follow-up of the patient revealed that eight months after the operation, the wound completely healed.

Keywords

• Surgical flaps
• diabetes mellitus
• type 2
• hand
• soft tissue infections
• candidiasis
• infection