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Case for Diagnosis. Presented by Gordon MacDonald, MD, and Joseph Gropen, MD.
Patient.—Seventeen-year-old male Caucasian.
History.—Onset of present illness was in summer of 1962 with hitting of left thumb with hammer. `Infection" and throbbing appeared within a week or so. He visited local physician who lanced thumb and cleaned it. Penicillin injection was given. Right thumb incised two weeks later because that finger was infected and did not heal. Patient left home for Virginia in September of this year (1962), noted throbbing of both thumbs and small finger of right hand. Soaks were employed. Physician in Bedford, Va, performed incision and drainage on left first and right first and fifth fingers followed by debridement.
Physical Examination.—Three digits involved with ulcerations, contractures, deformities as seen
Jan 9, 1963 here this afternoon. Questionable ulnar nerve enlargement.
Laboratory Data.—Smears of lesions, also nasal smear for acid-fast bacteria: negative. X-rays