Novel Infection Status Post Electrocution Requiring a 4th Ray Amputation

Authors

William R. Judson, HCA HealthcareFollow
John D. Murphy, HCA HealthcareFollow
Phillip H. Sussman, HCA HealthcareFollow
John N. Harker, HCA HealthcareFollow

Files

Division

West Florida

Hospital

Largo Medical Center

Specialty

Orthopedic Surgery

Document Type

Poster

Publication Date

5-2020

Keywords

Prevotella Biva, Prevotella Sp., Osteomyelitis, Tenosynovitis, Amputation, Infection

Disciplines

Bacterial Infections and Mycoses | Infectious Disease | Orthopedics | Surgical Procedures, Operative

Abstract

• Prevotella bivia is an anaerobic, non-pigmented, Gram-negative bacillus species that is known to inhabit the human female vaginal tract and oral flora. It is most commonly associated with endometritis and pelvic inflammatory disease.^{1, 2}
• Rarely, P. bivia has been found in the nail bed, chest wall, intervertebral discs, and hip and knee joints.¹ The bacteria has been linked to necrotizing fasciitis, osteomyelitis, or septic arthritis.^{3, 4}
• Only 3 other reports have described P. bivia infections in the upper extremity with one patient requiring amputation2, and one with deep soft tissue infection requiring multiple debridements and extensive tenosynovectomy.⁵
• Delays in diagnosis are common due to P. bivia’s long incubation period and association with aerobic organisms that more commonly cause soft tissue infections leading to inappropriate antibiotic coverage.
• Here we present a case on P. bivia that resulted in extensive tenosynovectomy, multiple irrigations and debridements and eventually amputation of the 4th ray and digit of the hand.

Recommended Citation

Judson, William R.; Murphy, John D.; Sussman, Phillip H.; and Harker, John N., "Novel Infection Status Post Electrocution Requiring a 4th Ray Amputation" (2020). West Florida Division Virtual Research Day 2020. 23.
https://scholarlycommons.hcahealthcare.com/westflorida2020/23