Although fungal infections of the hand and upper extremity are relatively uncommon,
they are now being reported with increasing frequency. Immunocompromised patients
are at especially high risk for these infections and hand surgeons should have a high
index of suspicion for fungal infections in susceptible immunocompromised and diabetic
patients and patients with hematologic malignancies and on chronic steroid medications.
Because fungal infections often present with an indolent onset, diagnosis and treatment
often are delayed. Definitive diagnosis only can be made with a surgical biopsy examination
and special fungal stains and cultures. Early aggressive surgical treatment includes
debridement of all involved soft tissues and bone, followed by adjuvant antifungal
therapy.
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© 2004 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
