Abstract
Acute hand infections in children are usually trauma-related or of spontaneous origin. This paper describes the spectrum of hand infections, highlights the underlying causes and identifies the common organisms.
Over two years 64 children, aged 6 months to 12 years, were seen. The duration of infection before presentation ranged from 2 to 38 days. The infection was palmar in 59 children and dorsal in five. It had developed spontaneously in 27 children, eight of whom had scabies. In 21 it was due to accidental injury (blunt trauma and penetration of needles, thorns and glass) and in 16 to inflicted injury (child abuse, animal bites, drip infiltrations and stabs). Associated medical infections were seen in four children. Seven were HIV positive.
All children underwent debridement and assessment in theatre. Surgery was repeated in nine (two to five times). Organisms cultured were Staphylococcus aureus (24), Pseudomonas (two) and Streptococcus pyogenes (one). Most healed well but 10 had contractures of the hand.
Thirty-eight per cent of cases of pyogenic infection admitted to our ward are acute. The majority present late, resulting in long hospitalisation. Cloxacillin is the first line of treatment. In children who are suspected to be HIV positive, the use of wide spectrum antibiotics is advisable.
The abstracts were edited by Prof. M.B.E. Sweet. Correspondence should be addressed to him at the Department of Orthopaedic Surgery, Medical School, University of the Witwatersrand, 7 York Road, Parktown, 2193 South Africa
